Provider Demographics
NPI:1730482092
Name:TITONE, ALEXANDRA
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:TITONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 VIA DE LA PAZ SUITE 100
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 VIA DE LA PAZ STE 100
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3538
Practice Address - Country:US
Practice Address - Phone:310-459-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0059299207Q00000X
FLOS14404207Q00000X
MA269569207Q00000X
MI5101022925207Q00000X
MN62731207Q00000X
NE1610207Q00000X
NVDO2396207Q00000X
NY259267207Q00000X
PAOS018957207Q00000X
TXP4253207Q00000X
WV3239207Q00000X
VA0102205396207Q00000X
CA20A11391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine