Healthcare Provider Details

I. General information

NPI: 1255035762
Provider Name (Legal Business Name): ALEXIS CASE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SAN MIGUEL DR STE 706
NEWPORT BEACH CA
92660-5927
US

IV. Provider business mailing address

360 SAN MIGUEL DR STE 706
NEWPORT BEACH CA
92660-5927
US

V. Phone/Fax

Practice location:
  • Phone: 949-646-7733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A25312
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: