Provider Demographics
NPI:1225649841
Name:FOU, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:FOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 TROJAN WAY APT 4413B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2702
Mailing Address - Country:US
Mailing Address - Phone:909-435-8434
Mailing Address - Fax:
Practice Address - Street 1:1508 CLAY ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2229
Practice Address - Country:US
Practice Address - Phone:909-435-8434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program