Provider Demographics
NPI:1508929001
Name:HURDLE, ALAIN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAIN
Middle Name:M
Last Name:HURDLE
Suffix:
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 1:117 W BUNNY AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-2805
Mailing Address - Country:US
Mailing Address - Phone:805-474-5807
Mailing Address - Fax:805-474-5808
Practice Address - Street 1:310 SOUTH HALCYON ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3863
Practice Address - Country:US
Practice Address - Phone:805-474-5807
Practice Address - Fax:805-474-5808
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2015-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG8584207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G85840Medicaid
CACB243348OtherMEDICARE ID
CAA58515Medicare UPIN