Basic Information
| Provider Information | |||||||||
| NPI: | 1194170431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOKSENIN | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | YASEMIN | ||||||||
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| Credential: | MD/PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 16TH ST, 4TH FL | ||||||||
| Address2: | BOX 0434 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154763831 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 16TH ST | ||||||||
| Address2: | 4TH FLOOR, 4551, BOX 0110 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154766245 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2016 | ||||||||
| LastUpdateDate: | 10/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A154408 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | A154408 | 01 | CA | MEDICAL BOARD OF CALIFORNIA | OTHER |