Healthcare Provider Details

I. General information

NPI: 1669799680
Provider Name (Legal Business Name): ALEXANDER NGUYEN ALI MALEKZADEH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 CONTRA COSTA BLVD # 1164
PLEASANT HILL CA
94523-3742
US

IV. Provider business mailing address

2120 CONTRA COSTA BLVD # 1164
PLEASANT HILL CA
94523-3742
US

V. Phone/Fax

Practice location:
  • Phone: 925-233-6931
  • Fax:
Mailing address:
  • Phone: 925-233-6931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A13830
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: