MEDICARE: MR. KENNETH STEVEN ALPERN MD

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	207N00000X	Dermatology Physician	A49395	CA

General Provider Information

NPI Number	:	1205830890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH STEVEN ALPERN MD

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1198 PACIFIC COAST HWY STE 1
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-6251
Country	:	US
Telephone Number	:	562-799-7071
Fax Number	:

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/23/2026

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