Healthcare Provider Details

I. General information

NPI: 1366444101
Provider Name (Legal Business Name): ALAN C NOEL SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date: 03/22/2006
Reactivation Date: 06/27/2006

III. Provider practice location address

8540 S SEPULVEDA BLVD SUITE 1002
LOS ANGELES CA
90045-3807
US

IV. Provider business mailing address

8540 S SEPULVEDA BLVD STE 1002
LOS ANGELES CA
90045-3808
US

V. Phone/Fax

Practice location:
  • Phone: 310-670-2085
  • Fax: 310-670-8258
Mailing address:
  • Phone: 310-670-2085
  • Fax: 310-670-8258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberC37160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: