Provider Demographics
NPI:1437718731
Name:ALEXANDER, BAYLEE JUSTINE (PA-C)
Entity type:Individual
Prefix:
First Name:BAYLEE
Middle Name:JUSTINE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:424-314-0125
Mailing Address - Fax:424-314-0128
Practice Address - Street 1:5411 ETIWANDA AVE STE 201
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6158
Practice Address - Country:US
Practice Address - Phone:424-314-0125
Practice Address - Fax:424-314-0128
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56869207R00000X, 2088F0040X
CAPA56869363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery