Provider Demographics
NPI:1720348758
Name:ALZATE, LIDIA (DC)
Entity Type:Individual
Prefix:DR
First Name:LIDIA
Middle Name:
Last Name:ALZATE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 W BURBANK BLVD
Mailing Address - Street 2:SUITE L
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1400
Mailing Address - Country:US
Mailing Address - Phone:818-842-7700
Mailing Address - Fax:818-842-7001
Practice Address - Street 1:916 W BURBANK BLVD
Practice Address - Street 2:SUITE L
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1400
Practice Address - Country:US
Practice Address - Phone:818-842-7700
Practice Address - Fax:818-842-7001
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor