Provider Demographics
NPI:1558578005
Name:ALEXANDER, EDWARD ANDREW SR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ANDREW
Last Name:ALEXANDER
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4460 OVERLAND AVE
Mailing Address - Street 2:APT 42
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4152
Mailing Address - Country:US
Mailing Address - Phone:310-753-2931
Mailing Address - Fax:
Practice Address - Street 1:4460 OVERLAND AVE APT 42
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4149
Practice Address - Country:US
Practice Address - Phone:310-753-2931
Practice Address - Fax:323-262-3109
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine