Healthcare Provider Details

I. General information

NPI: 1174516603
Provider Name (Legal Business Name): ALAN IRA COOK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 HOWARD HEIGHTS RD
EUREKA CA
95503-9570
US

IV. Provider business mailing address

341 HOWARD HEIGHTS RD
EUREKA CA
95503-9570
US

V. Phone/Fax

Practice location:
  • Phone: 707-444-8953
  • Fax:
Mailing address:
  • Phone: 707-444-8953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number19738
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: