Healthcare Provider Details

I. General information

NPI: 1851827315
Provider Name (Legal Business Name): MORGAN ALEXANDER WELCH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 TESCONI CT
SANTA ROSA CA
95401-4653
US

IV. Provider business mailing address

2104B SHORTRIDGE AVE
SAN JOSE CA
95116-2517
US

V. Phone/Fax

Practice location:
  • Phone: 707-623-9803
  • Fax:
Mailing address:
  • Phone: 913-636-7059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number19874
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number19874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: