Organization Name: | ALECSANDRA ROBERTS M.D., INC. |
NPI Number: | 1770759441 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALECSANDRA ROBERTS (OWNER) |
Mailing Address: | 400 S Sepulveda Blvd Suite 260 Manhattan Beach |
State: | CA US |
Postal Code: | 902666814 |
Phone Number: | 3103724488 |
Fax Number: | 3103724344 |
NPI Enumeration Date: | 05/02/2008 |
NPI Last Update Date: | 05/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G47706 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |