Provider Demographics
NPI:1740780790
Name:ADL, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ADL
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 1:2477 RANGE CREEK ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1602
Mailing Address - Country:US
Mailing Address - Phone:714-915-1337
Mailing Address - Fax:
Practice Address - Street 1:2477 RANGE CREEK ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1602
Practice Address - Country:US
Practice Address - Phone:714-915-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider