Provider Demographics
NPI:1811933021
Name:CZUBAKOWSKI, ALEXANDER WILLIAM (DC,)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:WILLIAM
Last Name:CZUBAKOWSKI
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 1:5530 CORBIN AVE # 100
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6094
Mailing Address - Country:US
Mailing Address - Phone:562-697-3700
Mailing Address - Fax:562-269-9718
Practice Address - Street 1:5530 CORBIN AVE # 100
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6094
Practice Address - Country:US
Practice Address - Phone:562-697-3700
Practice Address - Fax:562-269-9718
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27594Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER