Provider Demographics
NPI:1750317079
Name:ALEXANDER GERSHMAN MD APC
Entity Type:Organization
Organization Name:ALEXANDER GERSHMAN MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-623-1911
Mailing Address - Street 1:5901 W OLYMPIC BLVD STE 309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4664
Mailing Address - Country:US
Mailing Address - Phone:310-623-1911
Mailing Address - Fax:310-360-0999
Practice Address - Street 1:5901 W OLYMPIC BLVD STE 309
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4664
Practice Address - Country:US
Practice Address - Phone:310-623-1911
Practice Address - Fax:310-360-0999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA53738Medicare ID - Type Unspecified
CAG82355Medicare UPIN