| Organization Name: | ALEXIS LANE, M.D., INC. |
| NPI Number: | 1194105973 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALEXIS GRACE LANE (PRESIDENT, S-CORP) |
| Mailing Address: | 8055 Valencia St Aptos |
| State: | CA US |
| Postal Code: | 950033954 |
| Phone Number: | 8316888333 |
| Fax Number: | 8316888272 |
| NPI Enumeration Date: | 06/05/2015 |
| NPI Last Update Date: | 06/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YS0123X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in facial plastic surgery. |