Individual
DR. ALEXANDER ROUSSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4860 Y ST STE 2700, SACRAMENTO, CA 95817-2307
(916) 734-6688
(916) 734-6827
Mailing address
4860 Y ST STE 3020, SACRAMENTO, CA 95817-2307
(916) 734-6824
(916) 734-6827
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125071691
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
20A19536
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125071691
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
03/23/2018
Last updated
06/24/2022
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