Provider Demographics
NPI:1922384031
Name:MYLES, ALEXANDER V (LVN)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:V
Last Name:MYLES
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 PANSY LN
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-7804
Mailing Address - Country:US
Mailing Address - Phone:714-729-4957
Mailing Address - Fax:
Practice Address - Street 1:3815 PANSY LN
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-7804
Practice Address - Country:US
Practice Address - Phone:714-729-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 156890164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse