Provider Demographics
NPI:1417392523
Name:HARRISON, ALANA (DO)
Entity Type:Individual
Prefix:DR
First Name:ALANA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13768 ROSWELL AVE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710
Mailing Address - Country:US
Mailing Address - Phone:909-464-9119
Mailing Address - Fax:909-464-2201
Practice Address - Street 1:13768 ROSWELL AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710
Practice Address - Country:US
Practice Address - Phone:909-464-9119
Practice Address - Fax:909-464-2201
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A15993208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A15993OtherOSTEOPATHIC MEDICAL BOARD OF CALIFORNIA