MEDICARE: DR. BOBBY SIMON ALEXANDER M.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
1	208800000X	Urology Physician	269558	NY
2	208800000X	Urology Physician	A136864	CA

General Provider Information

NPI Number	:	1235575903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOBBY SIMON ALEXANDER M.D.

Provider Business Mailing Address
First Line	:	72650 FRED WARING DR STE 102
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-5007
Country	:	US
Telephone Number	:	760-346-1133
Fax Number	:	760-346-8857

Provider Business Practice Location Address
First Line	:	72650 FRED WARING DR STE 102
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-5007
Country	:	US
Telephone Number	:	760-346-1133
Fax Number	:	760-346-8857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2013
Last Update Date	:	10/22/2018

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