Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alexander Robert Jack, MD

Individual provider Dermatology Physician · NPI 1346482627

Alexander Robert Jack, MD is a Dermatology in Ladera Ranch, California. Graduated from University of Southern California Keck School of Medicine in 2009, 17 years ago. Practices with Elizabeth V Lener MD Inc, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2009
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

600 Corporate Dr Ste 240
Ladera Ranch, CA 92694-2111
Phone: (949) 364-8411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence C179601 (CA)

Record details

NPI number1346482627
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 1, 2009
Last updated in NPPESDecember 22, 2022
Certification dateDecember 22, 2022
Mailing addressPo Box 5127, Everett, WA 98206-5127

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Elizabeth V Lener Md Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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