Provider Demographics
NPI:1437718731
Name:ALEXANDER, BAYLEE JUSTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:BAYLEE
Middle Name:JUSTINE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19130 LOS ALIMOS ST
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2626
Mailing Address - Country:US
Mailing Address - Phone:919-442-3148
Mailing Address - Fax:
Practice Address - Street 1:18370 BURBANK BLVD STE 407
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2846
Practice Address - Country:US
Practice Address - Phone:818-208-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56869207R00000X, 2088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine