Individual provider Active NPI

Alejandra Green, M.D.

  • Internal Medicine Physician
  • Canyon Country, CA
National Provider Identifier
1205221694
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A151120 Issued in CA
Practice address
17909 Soledad Canyon Rd Ste 100
Canyon Country, CA 91387-3210
Phone
(661) 367-3500
NPI assigned
Apr 1, 2015
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2007137 CA
Internal Medicine Physician 207R00000X A151120 CA Primary

Addresses

Primary practice location

17909 Soledad Canyon Rd Ste 100
Canyon Country, CA 91387-3210

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other names 1

  • Alejandra Gutierrez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125002632 CA Practitioner - Internal Medicine 8123365343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3565 Del Amo Blvd
Torrance, CA 90503-1637
Phone (310) 214-0811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A151120CAMDInternal Medicine Physician
2007137CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 4, 2018 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

17909 Soledad Canyon Rd
Ste 100
Santa Clarita, CA 91387
Phone (661) 250-5200

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

3500 Lomita Blvd
Ste 203
Torrance, CA 90505
Phone (310) 326-0210

3565 Del Amo Blvd
Torrance, CA 90503

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: agreen205470@westdirect.optum.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1205221694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17909 SOLEDAD CANYON RD STE 100",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913873210",
            "telephone_number": "661-367-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALEJANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "2007137",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A151120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEJANDRA",
            "last_name": "GUTIERREZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canyon Country, CA

Sources for this page

Verify at the official NPI Registry.