Individual
MR. ALEXANDER B JOHN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2755 HERNDON AVENUE, CLOVIS, CA 93612-6800
(559) 324-4000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1100896
KY
367500000X
Certified Registered Nurse Anesthetist
054599
KY
367500000X
Certified Registered Nurse Anesthetist
99012653A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
NA2969
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000301355
ANTHEM
—
01
—
000000336278
ANTHEM
IN
05
—
200450490
—
IN
05
—
2442324
—
OH
01
—
P00250733
RAILROAD MEDICARE
IN
Enumeration date
07/13/2006
Last updated
04/16/2012
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