Healthcare Provider Details

I. General information

NPI: 1528404993
Provider Name (Legal Business Name): ALEXANDER DAVID NEUSNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 WILSHIRE BLVD ML01
BEVERLY HILLS CA
90212
US

IV. Provider business mailing address

9701 WILSHIRE BLVD ML01
BEVERLY HILLS CA
90212
US

V. Phone/Fax

Practice location:
  • Phone: 310-598-2648
  • Fax:
Mailing address:
  • Phone: 310-598-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberA185081
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT204058
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number56141
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: