Healthcare Provider Details

I. General information

NPI: 1902730716
Provider Name (Legal Business Name): ALEXANDER MAKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W 227TH ST
TORRANCE CA
90505-2246
US

IV. Provider business mailing address

4100 W 227TH ST
TORRANCE CA
90505-2246
US

V. Phone/Fax

Practice location:
  • Phone: 310-533-4524
  • Fax:
Mailing address:
  • Phone: 310-533-4524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number25133
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: