Provider Demographics
NPI:1427190651
Name:CONCEPCION, ALEXANDER R (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:R
Last Name:CONCEPCION
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:ALEXANDER
Other - Middle Name:R
Other - Last Name:CONCEPCION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:45-696 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4569
Mailing Address - Country:US
Mailing Address - Phone:808-235-0729
Mailing Address - Fax:808-263-3958
Practice Address - Street 1:45-696 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4569
Practice Address - Country:US
Practice Address - Phone:808-235-0729
Practice Address - Fax:808-263-3958
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10709542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH102457Medicare PIN