Provider Demographics
NPI:1356491567
Name:FIELD, ALEXANDER LOUIS (OD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:LOUIS
Last Name:FIELD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24400 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-1987
Mailing Address - Country:US
Mailing Address - Phone:951-677-5144
Mailing Address - Fax:951-698-1892
Practice Address - Street 1:24400 JACKSON AVE STE A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-1987
Practice Address - Country:US
Practice Address - Phone:951-677-5144
Practice Address - Fax:951-698-1892
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6026152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0060260Medicaid
CASD0060260Medicaid
CASD0060261Medicare ID - Type Unspecified