Provider Demographics
NPI:1467950493
Name:LIEN, ALAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:LIEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 OLD RIVER RD STE 125
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9506
Mailing Address - Country:US
Mailing Address - Phone:661-322-2700
Mailing Address - Fax:661-427-4587
Practice Address - Street 1:300 OLD RIVER RD STE 125
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9506
Practice Address - Country:US
Practice Address - Phone:661-322-2700
Practice Address - Fax:661-427-4587
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA0387363A00000X
CAPA60653363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant