Individual
MR. ALEX E DETRANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1600 W AVENUE J, LANCASTER, CA 93534-2814
(661) 949-5000
Mailing address
PO BOX 12380, WESTMINSTER, CA 92685-2380
(800) 592-6829
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18447
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA18447
MEDICAL LICENSE
CA
Enumeration date
11/01/2006
Last updated
07/31/2013
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