Provider Demographics
NPI:1184735953
Name:WILLIAM R ALEX MD INC
Entity type:Organization
Organization Name:WILLIAM R ALEX MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALEX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-732-4148
Mailing Address - Street 1:4000 14TH ST
Mailing Address - Street 2:STE 306
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-4083
Mailing Address - Country:US
Mailing Address - Phone:951-682-2036
Mailing Address - Fax:951-682-2942
Practice Address - Street 1:4000 14TH ST
Practice Address - Street 2:STE 306
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4083
Practice Address - Country:US
Practice Address - Phone:951-682-2036
Practice Address - Fax:951-682-2942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG860102086S0102X, 2086S0127X, 208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G860100Medicaid
00G860101Medicare PIN
CA00G860100Medicaid