Provider Demographics
NPI:1275765067
Name:VILLARASA, ALEXANDER ALCANTRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:ALCANTRA
Last Name:VILLARASA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:SUITE W400
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4800
Mailing Address - Country:US
Mailing Address - Phone:760-416-5010
Mailing Address - Fax:760-416-5001
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE W400
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-5010
Practice Address - Fax:760-416-5001
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
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Provider Licenses
StateLicense IDTaxonomies
CAA34432208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A344320Medicaid