MEDICARE: LAURA D ALEXANDER MD

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	A77654	CA

General Provider Information

NPI Number	:	1699763094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA D ALEXANDER MD

Provider Business Mailing Address
First Line	:	17530 VENTURA BLVD STE 201
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-3889
Country	:	US
Telephone Number	:	818-501-4421
Fax Number	:	818-789-6626

Provider Business Practice Location Address
First Line	:	1328 22ND ST
Second Line	:	DEPARTMENT OF ANESTHESIOLOGY
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2032
Country	:	US
Telephone Number	:	310-829-8202
Fax Number	:

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	03/03/2009

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