Healthcare Provider Details

I. General information

NPI: 1790910651
Provider Name (Legal Business Name): ALEXANDER MEJIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 E EL SEGUNDO BLVD STE 220
EL SEGUNDO CA
90245-2743
US

IV. Provider business mailing address

2110 E EL SEGUNDO BLVD STE 220
EL SEGUNDO CA
90245-2743
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-8745
  • Fax: 310-893-0431
Mailing address:
  • Phone: 310-784-8745
  • Fax: 310-893-0431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME1150657
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC194828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: