Provider Demographics
NPI:1346810843
Name:ARUCAN, ALEXANDER DANIEL ABARA
Entity Type:Individual
Prefix:
First Name:ALEXANDER DANIEL
Middle Name:ABARA
Last Name:ARUCAN
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 1:1029 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4529
Mailing Address - Country:US
Mailing Address - Phone:310-897-0233
Mailing Address - Fax:
Practice Address - Street 1:1029 CAMINO REAL
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-4529
Practice Address - Country:US
Practice Address - Phone:310-897-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist