Provider Demographics
NPI:1699842849
Name:FORD, ALEXANDER PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:PHILIP
Last Name:FORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S BEVERLY DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035
Mailing Address - Country:US
Mailing Address - Phone:310-277-6405
Mailing Address - Fax:310-277-2852
Practice Address - Street 1:1125 S BEVERLY DR
Practice Address - Street 2:SUITE 700
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035
Practice Address - Country:US
Practice Address - Phone:310-277-6405
Practice Address - Fax:310-277-2852
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG57387207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110159002OtherRAILROAD MEDICARE
CA110159002OtherRAILROAD MEDICARE
A60208Medicare UPIN