Healthcare Provider Details

I. General information

NPI: 1992394811
Provider Name (Legal Business Name): ALEXANDER GENG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 HYDE ST
SAN FRANCISCO CA
94109-4806
US

IV. Provider business mailing address

450 GLASS LN STE C
MODESTO CA
95356-9287
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-6420
  • Fax: 415-353-6259
Mailing address:
  • Phone: 209-342-2300
  • Fax: 209-524-4240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER B GENG
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 415-353-6420