MEDICARE: GEORGE ERIC ALEXANDER 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	207L00000X	Anesthesiology Physician	A44796	CA
2	208VP0000X	Pain Medicine Physician	A44796	CA
3	207R00000X	Internal Medicine Physician	A44796	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A44796	OTHER	CA	MEDICARE PTAN

General Provider Information

NPI Number	:	1558686832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE ERIC ALEXANDER A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	1711 VIA EL PRADO
Second Line	:	SUITE 202
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5714
Country	:	US
Telephone Number	:	310-316-1764
Fax Number	:	310-698-5777

Provider Business Practice Location Address
First Line	:	1711 VIA EL PRADO
Second Line	:	SUITE 202
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5714
Country	:	US
Telephone Number	:	310-316-1764
Fax Number	:	310-698-5777

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GEORGE ERIC ALEXANDER
Credential	:	M,D,
Telephone Number	:	310-316-1764

Provider Enumeration Date	:	03/30/2010
Last Update Date	:	03/13/2012

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Directions to “GEORGE ERIC ALEXANDER A MEDICAL CORPORATION ” Practice Location

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