Provider Demographics
NPI:1003270117
Name:GERTEL, ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:GERTEL
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 1:23550 HAWTHORNE BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4767
Mailing Address - Country:US
Mailing Address - Phone:310-891-6733
Mailing Address - Fax:310-257-7288
Practice Address - Street 1:23550 HAWTHORNE BLVD STE 125
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4767
Practice Address - Country:US
Practice Address - Phone:310-891-6733
Practice Address - Fax:310-257-7288
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA171197207Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology