MEDICARE: CARLY ALEXANDER M.D.

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	208000000X	Pediatrics Physician	148954	CA

General Provider Information

NPI Number	:	1063770980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY ALEXANDER M.D.

Provider Business Mailing Address
First Line	:	1547 TALMADGE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-1534
Country	:	US
Telephone Number	:	612-816-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 N LARCHMONT BLVD STE 1020
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-6410
Country	:	US
Telephone Number	:	323-960-8500
Fax Number	:

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

Provider Enumeration Date	:	04/28/2012
Last Update Date	:	07/21/2022

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Directions to “ CARLY ALEXANDER M.D.” Practice Location

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