Provider Demographics
NPI:1336139435
Name:HIRAHARA, ALAN M (MD FRCSC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:HIRAHARA
Suffix:
Gender:M
Credentials:MD FRCSC
Other - Prefix:DR
Other - First Name:ALAN
Other - Middle Name:M
Other - Last Name:HIRAHARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD FRCSC
Mailing Address - Street 1:2801 K ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5120
Mailing Address - Country:US
Mailing Address - Phone:916-732-3000
Mailing Address - Fax:916-732-3022
Practice Address - Street 1:2801 K ST
Practice Address - Street 2:SUITE 330
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5120
Practice Address - Country:US
Practice Address - Phone:916-733-5049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67496207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH39976Medicare UPIN