Basic Information
| Provider Information | |||||||||
| NPI: | 1386930600 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEKUROVSKY | ||||||||
| FirstName: | ALEXANDER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 N CIVIC DR | ||||||||
| Address2: | APT 306 | ||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945963368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084317790 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2175 N CALIFORNIA BLVD | ||||||||
| Address2: | STE 425 | ||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945963579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084317790 | ||||||||
| FaxNumber: | 9255430145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2011 | ||||||||
| LastUpdateDate: | 07/25/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | A135936 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.