MEDICARE: ALEXANDER MEDICAL GROUP

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	261QM2500X	Medical Specialty Clinic/Center	A44796	CA

Medicare Identifiers

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

General Provider Information

NPI Number	:	1720148703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDER MEDICAL GROUP

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	:

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	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. GEORGE ERIC ALEXANDER
Credential	:	MD
Telephone Number	:	310-316-1764

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	03/30/2010

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Directions to “ALEXANDER MEDICAL GROUP ” Practice Location

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