Provider Demographics
NPI:1497814685
Name:ALEXANDER, STANLEY J (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:J
Last Name:ALEXANDER
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 1:1505 S BALDWIN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7925
Mailing Address - Country:US
Mailing Address - Phone:626-446-1972
Mailing Address - Fax:
Practice Address - Street 1:1505 S BALDWIN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7925
Practice Address - Country:US
Practice Address - Phone:626-446-1972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA19343207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A193430OtherBLUE SHIELD
CA00A193430Medicaid
A82042Medicare UPIN
CA00A193430OtherBLUE SHIELD