MEDICARE: DR. ALEXANDER INGERMAN 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	208800000X	Urology Physician	G68271	CA
2	208800000X	Urology Physician	12487R	LA

General Provider Information

NPI Number	:	1588617021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER INGERMAN M.D.

Provider Business Mailing Address
First Line	:	833 N LAS PALMAS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3515
Country	:	US
Telephone Number	:	225-773-0474
Fax Number	:	225-269-8284

Provider Business Practice Location Address
First Line	:	833 N LAS PALMAS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3515
Country	:	US
Telephone Number	:	225-773-0474
Fax Number	:	225-269-8284

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	01/27/2022

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