Provider Demographics
NPI:1275755472
Name:MAGANA, ALEJANDRO (PA, DC)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:MAGANA
Suffix:
Gender:M
Credentials:PA, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 SAMARITAN DR STE 104B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4106
Mailing Address - Country:US
Mailing Address - Phone:408-356-8400
Mailing Address - Fax:855-834-6677
Practice Address - Street 1:2520 SAMARITAN DR STE 104B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4106
Practice Address - Country:US
Practice Address - Phone:408-356-8400
Practice Address - Fax:855-834-6677
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30450111N00000X
CAPA22114363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0030450Medicaid
CADC0030450Medicaid