Individual
ALEXANDRA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41990 COOK ST BLDG F, PALM DESERT, CA 92211-6100
(760) 565-5545
Mailing address
41990 COOK ST, PALM DESERT, CA 92211-6100
(760) 565-5545
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5982
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0444104
—
OH
Enumeration date
03/30/2018
Last updated
12/11/2024
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