Healthcare Provider Details

I. General information

NPI: 1073886651
Provider Name (Legal Business Name): ALAN LOUIS LAZAR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9988 DURANT DR
BEVERLY HILLS CA
90212-1603
US

IV. Provider business mailing address

9988 DURANT DR
BEVERLY HILLS CA
90212-1603
US

V. Phone/Fax

Practice location:
  • Phone: 310-497-8884
  • Fax:
Mailing address:
  • Phone: 310-497-8884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC21207
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: