Individual
ALEXANDER RAUL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
678 3RD AVE, CHULA VISTA, CA 91910-5736
(619) 662-4100
Mailing address
1275 30TH ST, SAN DIEGO, CA 92154-3476
(619) 662-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A133539
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A133539
MEDICAL LICENSE
CA
Enumeration date
06/14/2012
Last updated
08/20/2024
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