Provider Demographics
NPI:1528099124
Name:ALEXANDER, CINDY LAVON (DC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:LAVON
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 PEACOCK BLVD
Mailing Address - Street 2:STE H
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056
Mailing Address - Country:US
Mailing Address - Phone:760-639-1101
Mailing Address - Fax:760-639-1171
Practice Address - Street 1:1820 PEACOCK BLVD
Practice Address - Street 2:STE H
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-639-1101
Practice Address - Fax:760-639-1171
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U98210Medicare UPIN