MEDICARE: LANCELOT O ALEXANDER MD A MEDICAL CORPORATION

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
1	174400000X	Specialist	G52251	CA

General Provider Information

NPI Number	:	1134279532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANCELOT O ALEXANDER MD A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 4363
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93912-4363
Country	:	US
Telephone Number	:	831-649-1000
Fax Number	:	831-649-4962

Provider Business Practice Location Address
First Line	:	535 E ROMIE LN
Second Line	:	1
City	:	SALINAS
State	:	CA
Zip	:	93901-4026
Country	:	US
Telephone Number	:	831-422-7195
Fax Number	:	831-422-7309

Authorized Official
Title or Position	:	OWNER
Name	:	LANCELOT O ALEXANDER
Credential	:	M.D.
Telephone Number	:	831-422-7195

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	08/23/2011

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