MEDICARE: DR. ALEXANDRA GANGI M.D.

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	208600000X	Surgery Physician	A 116318	CA
2	2086X0206X	Surgical Oncology Physician	A116318	CA

General Provider Information

NPI Number	:	1932498110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA GANGI M.D.

Provider Business Mailing Address
First Line	:	8700 BEVERLY BLVD
Second Line	:	#8215 NT
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1804
Country	:	US
Telephone Number	:	310-423-6746
Fax Number	:	310-423-7596

Provider Business Practice Location Address
First Line	:	8700 BEVERLY BLVD # 8215
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1804
Country	:	US
Telephone Number	:	310-423-6746
Fax Number	:

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

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	08/26/2020

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