Healthcare Provider Details

I. General information

NPI: 1033280920
Provider Name (Legal Business Name): ALEXANDER SHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 DELAWARE ST
LONGVIEW WA
98632-2367
US

IV. Provider business mailing address

4733 W SUNSET BLVD
LOS ANGELES CA
90027-6021
US

V. Phone/Fax

Practice location:
  • Phone: 360-414-7878
  • Fax: 360-414-7876
Mailing address:
  • Phone: 310-658-4533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberMD61259421
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA67311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: