Provider Demographics
NPI:1649279365
Name:BADER, ALAN S (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:BADER
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 1:294 E MOANA LN
Mailing Address - Street 2:STE 28
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4641
Mailing Address - Country:US
Mailing Address - Phone:775-829-7575
Mailing Address - Fax:775-829-7755
Practice Address - Street 1:294 E MOANA LN
Practice Address - Street 2:STE 28
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4641
Practice Address - Country:US
Practice Address - Phone:775-829-7575
Practice Address - Fax:775-829-7755
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV-B-567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV34422Medicare PIN