Provider Demographics
NPI:1225417322
Name:ALEXANDER, ATHENA THERESA (MD)
Entity type:Individual
Prefix:DR
First Name:ATHENA
Middle Name:THERESA
Last Name:ALEXANDER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1206 E 17TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2641
Mailing Address - Country:US
Mailing Address - Phone:714-352-2911
Mailing Address - Fax:714-352-2903
Practice Address - Street 1:1206 E 17TH ST STE 101
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2641
Practice Address - Country:US
Practice Address - Phone:714-352-2911
Practice Address - Fax:714-352-2903
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135990207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine