Provider Demographics
NPI:1114130879
Name:MOSKOWITZ, ALLAN W (DC, CFP)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:W
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:DC, CFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 VALE RD
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3816
Mailing Address - Country:US
Mailing Address - Phone:510-215-6700
Mailing Address - Fax:
Practice Address - Street 1:4206 LEAD AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2707
Practice Address - Country:US
Practice Address - Phone:510-215-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor