Provider Demographics
NPI:1275606600
Name:ALAM, ZIYAD H (DC)
Entity Type:Individual
Prefix:DR
First Name:ZIYAD
Middle Name:H
Last Name:ALAM
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 1:235 N LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3500
Mailing Address - Country:US
Mailing Address - Phone:909-988-2554
Mailing Address - Fax:909-988-2584
Practice Address - Street 1:17096 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3500
Practice Address - Country:US
Practice Address - Phone:909-428-6989
Practice Address - Fax:909-428-6939
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26668111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation