Provider Demographics
NPI:1396938924
Name:HESHMAT, ALEN (DC)
Entity type:Individual
Prefix:DR
First Name:ALEN
Middle Name:
Last Name:HESHMAT
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 1:1314 W GLENOAKS BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3256
Mailing Address - Country:US
Mailing Address - Phone:818-696-2226
Mailing Address - Fax:
Practice Address - Street 1:1314 W GLENOAKS BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-3256
Practice Address - Country:US
Practice Address - Phone:818-696-2226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor