Healthcare Provider Details

I. General information

NPI: 1154249571
Provider Name (Legal Business Name): ALEXIS PAUL ISAEV DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FLORIDA AVE STE 102
MODESTO CA
95350-4446
US

IV. Provider business mailing address

232 MARGARITA AVE
PALO ALTO CA
94306-2822
US

V. Phone/Fax

Practice location:
  • Phone: 209-573-6181
  • Fax:
Mailing address:
  • Phone: 650-704-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: