Basic Information
| Provider Information | |||||||||
| NPI: | 1760431654 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEIN | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | DORU | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 FOURTH AVE STE 14 | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919103813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6193033681 | ||||||||
| FaxNumber: | 6192580028 | ||||||||
| Practice Location | |||||||||
| Address1: | 340 FOURTH AVE STE 14 | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187536536 | ||||||||
| FaxNumber: | 6192580028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2006 | ||||||||
| LastUpdateDate: | 02/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | MD036056 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207N00000X | A106295 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.