Provider Demographics
NPI:1336182757
Name:HOROWITZ, ALFRED L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:L
Last Name:HOROWITZ
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 1:927 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:927 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94708-1449
Practice Address - Country:US
Practice Address - Phone:510-548-7634
Practice Address - Fax:888-633-8231
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG221712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC132ATOtherBCBSNC
SCN00238Medicaid
NC89-132ATMedicaid
NCE24357Medicare UPIN
NC2006758Medicare ID - Type Unspecified
CAAQ402ZMedicare PIN