Provider Demographics
NPI:1801029954
Name:ALEX DENES, MD, FACP, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ALEX DENES, MD, FACP, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:DENES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-925-6969
Mailing Address - Street 1:31630 RAILROAD CANYON RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-9477
Mailing Address - Country:US
Mailing Address - Phone:951-925-6969
Mailing Address - Fax:951-244-9622
Practice Address - Street 1:31630 RAILROAD CANYON RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-9477
Practice Address - Country:US
Practice Address - Phone:951-925-6969
Practice Address - Fax:951-244-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG269770282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital