Provider Demographics
NPI:1033251418
Name:IVAR, ALAN CRAIG (DC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:CRAIG
Last Name:IVAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4958
Mailing Address - Country:US
Mailing Address - Phone:714-662-2711
Mailing Address - Fax:714-662-3502
Practice Address - Street 1:1650 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4958
Practice Address - Country:US
Practice Address - Phone:714-662-2711
Practice Address - Fax:714-662-3502
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor