Provider Demographics
NPI:1528032562
Name:ETEMAD, ALEX H (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:H
Last Name:ETEMAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16702 VALLEY VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5824
Mailing Address - Country:US
Mailing Address - Phone:714-367-5360
Mailing Address - Fax:714-635-5428
Practice Address - Street 1:5584 N PARAMOUNT BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-5133
Practice Address - Country:US
Practice Address - Phone:562-920-8394
Practice Address - Fax:562-867-6083
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC50563207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOC505630Medicare PIN
CACK061YMedicare PIN
CAWC50563DMedicare PIN
CAH62739Medicare UPIN
CAWC50563CMedicare PIN