Provider Demographics
NPI:1043579808
Name:ALWEN, DENNIS (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:ALWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25408 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6123
Mailing Address - Country:US
Mailing Address - Phone:818-518-5980
Mailing Address - Fax:
Practice Address - Street 1:6200 CANOGA AVE STE 450
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7464
Practice Address - Country:US
Practice Address - Phone:818-518-5980
Practice Address - Fax:818-337-2049
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14218149-1205208600000X
CAA121235208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery