Provider Demographics
NPI:1104972736
Name:ALEXANDER, JULIAN P III (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:P
Last Name:ALEXANDER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2747
Mailing Address - Country:US
Mailing Address - Phone:530-529-1750
Mailing Address - Fax:530-529-4551
Practice Address - Street 1:1056 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2747
Practice Address - Country:US
Practice Address - Phone:530-529-1750
Practice Address - Fax:530-529-4551
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41692207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0045250Medicaid
CAGR0045250Medicaid
CA00G416920Medicare ID - Type Unspecified