Provider Demographics
NPI:1902255367
Name:DE CASTRO-ABEGER, ALEXANDER H (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:H
Last Name:DE CASTRO-ABEGER
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 AVIATION BLVD # 202
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2851
Mailing Address - Country:US
Mailing Address - Phone:310-374-2727
Mailing Address - Fax:
Practice Address - Street 1:2230 LYNN RD STE 104
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1959
Practice Address - Country:US
Practice Address - Phone:805-495-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA267421207R00000X
TN61036207W00000X
CAA171995207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine