Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | G267240 | CA |
NPI | 1053321760 |
---|---|
Provider Name | Michael Alexander |
First Address | Santa Cruz, CA 95065 |
Second Address | Santa Cruz, CA 95065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 18/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A43081 | (02) |