Provider Demographics
NPI:1295742047
Name:FEDER, ALLAN P (DC)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:P
Last Name:FEDER
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 1:11421 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-3121
Mailing Address - Country:US
Mailing Address - Phone:562-692-9643
Mailing Address - Fax:562-692-9966
Practice Address - Street 1:11421 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-3121
Practice Address - Country:US
Practice Address - Phone:562-692-9643
Practice Address - Fax:562-692-9966
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14025Medicare ID - Type Unspecified
DC14025Medicare UPIN