Healthcare Provider Details

I. General information

NPI: 1255458741
Provider Name (Legal Business Name): ALEXANDER ORTHOPEDIC SURGERY AND SPORTS MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28780 SINGLE OAK DR STE 270
TEMECULA CA
92590-5534
US

IV. Provider business mailing address

PO BOX 573
TEMECULA CA
92593
US

V. Phone/Fax

Practice location:
  • Phone: 951-600-1795
  • Fax: 951-308-1522
Mailing address:
  • Phone: 951-600-1795
  • Fax: 951-308-1522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BRUCE ALEXANDER
Title or Position: PRESIDENT
Credential: MD
Phone: 951-600-1795