Provider Demographics
NPI:1124058219
Name:GERSHMAN, ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:GERSHMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 WILSHIRE BLVD STE 701
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5509
Mailing Address - Country:US
Mailing Address - Phone:310-623-1911
Mailing Address - Fax:310-623-1922
Practice Address - Street 1:6404 WILSHIRE BLVD STE 701
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5509
Practice Address - Country:US
Practice Address - Phone:310-623-1911
Practice Address - Fax:310-623-1922
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53738174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA53738Medicare ID - Type Unspecified