Provider Demographics
NPI:1538115571
Name:ASLAN, ALEX A (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:A
Last Name:ASLAN
Suffix:
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 1:2222 EAST ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2066
Mailing Address - Country:US
Mailing Address - Phone:925-685-7730
Mailing Address - Fax:
Practice Address - Street 1:2222 EAST ST STE 300
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2066
Practice Address - Country:US
Practice Address - Phone:925-682-7730
Practice Address - Fax:925-754-0765
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62211207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G622110Medicaid
CA00G622110Medicare ID - Type Unspecified