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1528009990

NPI Code Detail

MEDICARE: ALEXANDER P IEROKOMOS M.D.

MEDICARE: ALEXANDER P IEROKOMOS 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	207YS0012X	Sleep Medicine (Otolaryngology) Physician	MD00022010	WA
2	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	MD00022010	WA
3	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	MD00022010	WA
4	207YX0602X	Otolaryngic Allergy Physician	MD00022010	WA
5	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	MD00022010	WA
6	207Y00000X	Otolaryngology Physician	G41004	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0060170	OTHER	WA	LABOR AND INDUSTRIES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528009990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER P IEROKOMOS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1020
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95201-3120
Country	:	US
Telephone Number	:	209-468-6000
Fax Number	:	209-468-7042

Provider Business Practice Location Address
First Line	:	500 W HOSPITAL RD
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-9693
Country	:	US
Telephone Number	:	209-468-6000
Fax Number	:	209-468-7042

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	05/03/2013

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Directions to “ ALEXANDER P IEROKOMOS M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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