Provider Demographics
NPI:1861504730
Name:LOW, ALEXANDER HUGH (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:HUGH
Last Name:LOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 CREEKSIDE DR
Mailing Address - Street 2:STE 220
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3888
Mailing Address - Country:US
Mailing Address - Phone:530-622-6430
Mailing Address - Fax:530-622-1016
Practice Address - Street 1:1580 CREEKSIDE DR
Practice Address - Street 2:STE 220
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3888
Practice Address - Country:US
Practice Address - Phone:530-622-6430
Practice Address - Fax:530-622-1016
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG780821174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0048710Medicaid
CAZZZ20819ZMedicare PIN
00G780822Medicare ID - Type Unspecified
CAGR0048710Medicaid
CAZZZ22929ZMedicare PIN