Provider Demographics
NPI:1710963400
Name:ALEXANDER, ANDREW G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:G
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:913 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CALISTOGA
Mailing Address - State:CA
Mailing Address - Zip Code:94515-1433
Mailing Address - Country:US
Mailing Address - Phone:707-942-6233
Mailing Address - Fax:707-942-6382
Practice Address - Street 1:913 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1433
Practice Address - Country:US
Practice Address - Phone:707-942-6233
Practice Address - Fax:707-942-6382
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG50850207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G508501Medicaid
CAA51828Medicare UPIN
CA00G508501Medicaid