Provider Demographics
NPI:1417951963
Name:GIL, ALEJANDRO ESTEBAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:ESTEBAN
Last Name:GIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29157
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-0157
Mailing Address - Country:US
Mailing Address - Phone:213-389-9100
Mailing Address - Fax:213-389-9102
Practice Address - Street 1:240 N VIRGIL AVE STE 7
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-5293
Practice Address - Country:US
Practice Address - Phone:213-389-9100
Practice Address - Fax:213-389-9102
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A375580Medicaid
CA00A375580Medicaid
CAA37558AMedicare PIN