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Individual

ALICE DRAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
200 MEDICAL PLAZA DRIVEWAY SUITE 140, LOS ANGELES, CA 90095-6402
(833) 825-2974
Mailing address
379 CAMPUS DR FL 4, SOMERSET, NJ 08873-1161

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA12203600
NJ
208800000X
Urology Physician
A180985
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
04/20/2017
Last updated
04/25/2024
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