MEDICARE: ALEXANDER NEUSNER MD, INC

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	2086S0122X	Plastic and Reconstructive Surgery Physician

General Provider Information

NPI Number	:	1609699180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDER NEUSNER MD, INC

Provider Business Mailing Address
First Line	:	13428 CONTOUR DR
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-4804
Country	:	US
Telephone Number	:	860-912-4076
Fax Number	:

Provider Business Practice Location Address
First Line	:	9701 WILSHIRE BLVD
Second Line	:	ML01
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2020
Country	:	US
Telephone Number	:	310-598-2648
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	ALEXANDER NEUSNER
Credential	:	MD
Telephone Number	:	860-912-4076

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/04/2024

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