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General NPI Number Information
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NPI Number | 1194764530
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Entity Type | Individual
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Provider Name | ALEXANDER DUSOVICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2701 W ALAMEDA AVE #503
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City | BURBANK
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State | CA
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Zip | 91505-4402
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Country | US
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Telephone | 818-845-0088
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Fax | 818-845-0924
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Provider Business Mailing Address
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Address Line | 8306 WILSHIRE BLVD #501
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2382
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Country | US
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Telephone | 310-613-2414
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Fax | 805-494-8379
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A55901
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License Number State | CA
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