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MR. KENNETH CHARLES ALEXANDER PA

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1174506828

Individual Registrant:
MR. KENNETH CHARLES ALEXANDER PA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
13193 CENTRAL AVENUE SUITE 200 CHINO, CA 91710 US
Tel: 909-902-9111  Fax: 909-902-9199

Contact information for business:
13193 CENTRAL AVENUE SUITE 200 CHINO, CA 91710 US
Tel: 909-902-9111  Fax: 909-902-9199

Registration Information:
NPI: 1174506828
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
CAPA10648

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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