Basic Information
| Provider Information | |||||||||
| NPI: | 1598819419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMBANIS | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D., MTROPMED | ||||||||
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| OtherLastName: | CAMBANIS | ||||||||
| OtherFirstName: | ALEXANDRONS | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 12291 WASHINGTON BLVD | ||||||||
| Address2: | PIH FAMILY PRACTICE CENTER | ||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906062500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626982541 | ||||||||
| FaxNumber: | 5626984981 | ||||||||
| Practice Location | |||||||||
| Address1: | 12291 WASHINGTON BLVD | ||||||||
| Address2: | PIH FAMILY PRACTICE CENTER | ||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906062500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626982541 | ||||||||
| FaxNumber: | 5626984981 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A72127 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | NC | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.