Individual
DR. ALEXANDER JOHN KLISTOFF JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11583 C AVE, AUBURN, CA 95603-2703
(530) 886-3454
(530) 889-7276
Mailing address
11583 C AVE, AUBURN, CA 95603-2703
(530) 886-3454
(530) 889-7276
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G37960
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G379600
PIN # MEDICARE
CA
01
—
G37960
LICENSE NUMBER
CA
Enumeration date
11/14/2006
Last updated
03/07/2023
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