Provider Demographics
NPI:1609861236
Name:NUNEZ, ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N MARYLAND AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4262
Mailing Address - Country:US
Mailing Address - Phone:818-247-4411
Mailing Address - Fax:818-247-4845
Practice Address - Street 1:200 N MARYLAND AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4262
Practice Address - Country:US
Practice Address - Phone:818-247-4411
Practice Address - Fax:818-247-4845
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT18041Medicare UPIN