Basic Information
Provider Information
NPI: 1760864367
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHERMAN
FirstName: ALEXANDER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
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OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018771
FaxNumber:  
Practice Location
Address1: 200 UCLA MEDICAL PLZ STE 365B
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900951690
CountryCode: US
TelephoneNumber: 3108257921
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/19/2015
LastUpdateDate: 08/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA155017CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001XA155017CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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