Healthcare Provider Details

I. General information

NPI: 1992972897
Provider Name (Legal Business Name): ALEXANDRA DRAKAKI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2008
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 SANTA MONICA BLVD SUITE 600
SANTA MONICA CA
90404-2023
US

IV. Provider business mailing address

5767 W. CENTURY BLVD, SUITE 400
LOS ANGELES CA
90045-5655
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-5471
  • Fax: 310-829-6192
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberA124517
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA124517
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA124517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: