Basic Information
| Provider Information | |||||||||
| NPI: | 1942284831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DE MORAES | ||||||||
| FirstName: | ALEXANDRE | ||||||||
| MiddleName: | ANTONIO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3010 BEARD RD | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945583442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072558825 | ||||||||
| FaxNumber: | 7072529325 | ||||||||
| Practice Location | |||||||||
| Address1: | 3010 BEARD RD | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945583442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072571550 | ||||||||
| FaxNumber: | 7072578219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2005 | ||||||||
| LastUpdateDate: | 06/20/2016 | ||||||||
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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 | MD60183294 | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A66851 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.