Provider Demographics
NPI:1801214317
Name:STERN, ALEXANDRIA LILA (DPM)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:LILA
Last Name:STERN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 MARY ELLEN AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-1819
Mailing Address - Country:US
Mailing Address - Phone:818-207-2292
Mailing Address - Fax:
Practice Address - Street 1:12265 VENTURA BLVD STE 107
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2530
Practice Address - Country:US
Practice Address - Phone:310-691-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5355213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery