Provider Demographics
NPI:1609359686
Name:ALEXIS HEALTHCARE CORP
Entity Type:Organization
Organization Name:ALEXIS HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:KO
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIUO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:949-981-4515
Mailing Address - Street 1:35 FIELD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3345
Mailing Address - Country:US
Mailing Address - Phone:949-981-4515
Mailing Address - Fax:
Practice Address - Street 1:35 FIELD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3345
Practice Address - Country:US
Practice Address - Phone:949-981-4515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95001948OtherBOARD OF REGISTERED NURSING