Healthcare Provider Details

I. General information

NPI: 1255378303
Provider Name (Legal Business Name): MAGDI G ALEXANDER F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BELLEFONTAINE ST STE 409
PASADENA CA
91105-3132
US

IV. Provider business mailing address

50 BELLEFONTAINE ST STE 409
PASADENA CA
91105-3132
US

V. Phone/Fax

Practice location:
  • Phone: 626-431-2710
  • Fax: 626-229-7566
Mailing address:
  • Phone: 626-431-2710
  • Fax: 626-229-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG079508
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG07508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: