MEDICARE: MS. ALEXANDRA CATHERINE SPECTOR R.N

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	464876	CA

General Provider Information

NPI Number	:	1063668804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALEXANDRA CATHERINE SPECTOR R.N

Provider Business Mailing Address
First Line	:	11848 MEAJEAN PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-4935
Country	:	US
Telephone Number	:	619-203-8426
Fax Number	:

Provider Business Practice Location Address
First Line	:	2603 DENVER ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-3342
Country	:	US
Telephone Number	:	619-203-8426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	01/12/2015

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