Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 166277 | CA |
NPI | 1043708860 |
---|---|
Provider Name | Alexander George Chartrain |
First Address | Los Angeles, CA 90033-1083 |
Second Address | Los Angeles, CA 90033-1083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2018 |
Last Update Date | 08/11/2019 |