Healthcare Provider Details

I. General information

NPI: 1013826619
Provider Name (Legal Business Name): SAMUEL HANS ALPERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SAM ALPERT

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SEA HAWK WAY
REDONDO BEACH CA
90277-2976
US

IV. Provider business mailing address

1 SEA HAWK WAY
REDONDO BEACH CA
90277-2976
US

V. Phone/Fax

Practice location:
  • Phone: 310-978-8665
  • Fax:
Mailing address:
  • Phone: 310-978-8665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number79A4D88D37
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: