Provider Demographics
NPI:1265595136
Name:ALEXANDER, GEORGE E (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:E
Last Name:ALEXANDER
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 1:1711 VIA EL PRADO
Mailing Address - Street 2:202
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5714
Mailing Address - Country:US
Mailing Address - Phone:310-316-1764
Mailing Address - Fax:310-316-1764
Practice Address - Street 1:1711 VIA EL PRADO
Practice Address - Street 2:202
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5714
Practice Address - Country:US
Practice Address - Phone:310-316-1764
Practice Address - Fax:310-316-1764
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44796207L00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A447960Medicaid
F06975Medicare UPIN
CAWA44796BMedicare ID - Type Unspecified