Individual
ALEXANDER CO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3930 W VALENCIA DR APT 3, FULLERTON, CA 92833-5807
(714) 335-8299
Mailing address
1030 W WARNER AVE, SANTA ANA, CA 92707-3147
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95279831
CA
Other
Enumeration date
04/28/2022
Last updated
04/28/2022
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