Healthcare Provider Details

I. General information

NPI: 1942284831
Provider Name (Legal Business Name): ALEXANDRE ANTONIO DE MORAES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2005
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 BEARD RD
NAPA CA
94558-3442
US

IV. Provider business mailing address

3010 BEARD RD
NAPA CA
94558-3442
US

V. Phone/Fax

Practice location:
  • Phone: 707-257-1550
  • Fax: 707-257-8219
Mailing address:
  • Phone: 707-255-8825
  • Fax: 707-252-9325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA66851
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60183294
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: