Provider Demographics
NPI:1366444101
Name:NOEL, ALAN C SR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:NOEL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 S SEPULVEDA BLVD STE 1002
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3808
Mailing Address - Country:US
Mailing Address - Phone:310-670-2085
Mailing Address - Fax:310-670-8258
Practice Address - Street 1:8540 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 1002
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3807
Practice Address - Country:US
Practice Address - Phone:310-670-2085
Practice Address - Fax:310-670-8258
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2019-06-28
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-06-27
Provider Licenses
StateLicense IDTaxonomies
CAC37160207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C371600Medicaid
CA00C371600Medicaid