John Howard Alexander, PA-C

Individual provider Active NPI Medical Physician Assistant · Vallejo, CA

NPI 1023056983 · NPPES record last updated Aug 21, 2007

Key facts

NPI
1023056983
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
PA14144 (CA)
Practice address
2290 Sacramento St
Vallejo, CA 94590-2929
Phone
(707) 643-5785
Fax
(707) 643-8810
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PA14144CAMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14144 CA Yes

Addresses

Primary practice location

2290 Sacramento St
Vallejo, CA 94590-2929

Mailing address

2290 Sacramento St
Vallejo, CA 94590-2929
Phone (707) 643-5785

Other identifiers

IdentifierTypeStateIssuer
GR0023150MedicaidCA

Other providers in Vallejo, CA

All providers in Vallejo, CA · Medical Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.