Healthcare Provider Details

I. General information

NPI: 1649031550
Provider Name (Legal Business Name): ALEXANDRA MEGHAN DIMOSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9781 BLUE LARKSPUR LN
MONTEREY CA
93940-6509
US

IV. Provider business mailing address

1450 N MAIN ST
SALINAS CA
93906-5100
US

V. Phone/Fax

Practice location:
  • Phone: 831-333-9008
  • Fax: 831-333-9010
Mailing address:
  • Phone: 831-772-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number64766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: