Provider Demographics
NPI:1710907217
Name:SCHROEDER, ALAN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROBERT
Last Name:SCHROEDER
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 1:38 S LA CUMBRE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-6130
Mailing Address - Country:US
Mailing Address - Phone:805-692-4933
Mailing Address - Fax:805-964-0552
Practice Address - Street 1:38 S LA CUMBRE RD STE 2
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-6130
Practice Address - Country:US
Practice Address - Phone:805-692-4933
Practice Address - Fax:805-964-0552
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0110310Medicaid
CADC11031Medicare ID - Type Unspecified
CADC0110310Medicaid