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General NPI Number Information
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NPI Number | 1063511475
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Entity Type | Organization
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Legal Business Name | ALEXANDER P. HERSEL, M.D., INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 1120 NEWBURY RD # 150
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-3663
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Country | US
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Telephone | 805-557-0096
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Fax | 805-557-7360
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Provider Business Mailing Address
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Address Line | 415 ROLLING OAKS DR 110
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1029
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Country | US
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Telephone | 805-557-0096
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Fax | 805-557-7360
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER P HERSEL
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Credential |
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Telephone | 805-367-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A79277
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A79277
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License Number State | CA
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