Healthcare Provider Details

I. General information

NPI: 1790721025
Provider Name (Legal Business Name): GERALD JOHN ALEXANDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 S MAIN ST STE 200
ORANGE CA
92868-3852
US

IV. Provider business mailing address

280 S MAIN ST STE 200
ORANGE CA
92868-3852
US

V. Phone/Fax

Practice location:
  • Phone: 714-634-4567
  • Fax:
Mailing address:
  • Phone: 714-634-4567
  • Fax: 714-634-4569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG81353
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG81353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: