Provider Demographics
NPI:1629173745
Name:MCNABB, ALAN G (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:G
Last Name:MCNABB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5 MEDICAL PLAZA DR.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:916-781-2500
Mailing Address - Fax:916-782-9424
Practice Address - Street 1:5 MEDICAL PLAZA DR.
Practice Address - Street 2:SUITE 120
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-781-2500
Practice Address - Fax:916-782-9424
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2017-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG66808208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G668980Medicaid
H09913Medicare UPIN
CA00G668980Medicaid