MEDICARE: DR. ALEXANDRA REED MYERS D.O.

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	207QS0010X	Sports Medicine (Family Medicine) Physician	20A11819	CA

General Provider Information

NPI Number	:	1386922904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA REED MYERS D.O.

Provider Business Mailing Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2100
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5244
Country	:	US
Telephone Number	:	619-229-3922
Fax Number	:	619-229-3902

Provider Business Practice Location Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2100
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5244
Country	:	US
Telephone Number	:	619-229-3922
Fax Number	:	619-229-3902

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

Provider Enumeration Date	:	07/31/2011
Last Update Date	:	08/26/2014

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