Provider Demographics
NPI:1770514945
Name:ALAN E. GORENBERG MD, INC.
Entity type:Organization
Organization Name:ALAN E. GORENBERG MD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GORENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-633-4666
Mailing Address - Street 1:8506 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-2461
Mailing Address - Country:US
Mailing Address - Phone:714-633-4666
Mailing Address - Fax:714-633-4640
Practice Address - Street 1:8506 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-2461
Practice Address - Country:US
Practice Address - Phone:714-633-4666
Practice Address - Fax:714-633-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60876174400000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1730115221OtherNPI (INDIVIDUAL)
CA1770514945OtherNPI (INCORPERATED)
CAG60876OtherMEDICAL LIC.
CA1770514945OtherNPI (INCORPERATED)
CAZZZ03747ZMedicare PIN
CAP00292900Medicare PIN
CAE93428Medicare UPIN
CADE4387Medicare PIN
CAG60876OtherMEDICAL LIC.
CA00G608761Medicare PIN
CAW20699Medicare PIN