Provider Demographics
NPI:1689905424
Name:ALGER, ANTHONY WAYNE
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WAYNE
Last Name:ALGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 CENTENNIAL AVE
Mailing Address - Street 2:UNIT. B
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3979
Mailing Address - Country:US
Mailing Address - Phone:949-275-7733
Mailing Address - Fax:
Practice Address - Street 1:COST GUARD ISLAND BUILDING 1
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501
Practice Address - Country:US
Practice Address - Phone:510-437-3827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider