Provider Demographics
NPI:1811429921
Name:CARLIN, ALEXANDER LOCKETT (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:LOCKETT
Last Name:CARLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:510-504-8440
Mailing Address - Fax:510-506-7721
Practice Address - Street 1:2850 TELEGRAPH AVE STE 110
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1159
Practice Address - Country:US
Practice Address - Phone:510-204-8440
Practice Address - Fax:510-506-7721
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A173352084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A17335OtherSTATE MEDICAL LICENSE