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NPI Code Detail

MEDICARE: DR. ALEXA K ALTMAN PH.D.

MEDICARE:  DR. ALEXA K ALTMAN  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY20323CA

General Provider Information

NPI Number : 1043452840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXA K ALTMAN PH.D.
Provider Business Mailing Address
First Line : 11704 WILSHIRE BLVD STE 255
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1504
Country : US
Telephone Number : 323-414-4141
Fax Number :
Provider Business Practice Location Address
First Line : 11704 WILSHIRE BLVD STE 255
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1504
Country : US
Telephone Number : 323-414-4141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2009
Last Update Date : 03/26/2009

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