Healthcare Provider Details

I. General information

NPI: 1457420812
Provider Name (Legal Business Name): DAVID ALPAN DDS, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 W 3RD ST
LOS ANGELES CA
90057-1908
US

IV. Provider business mailing address

2424 W 3RD ST
LOS ANGELES CA
90057-1908
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-8228
  • Fax: 213-382-8244
Mailing address:
  • Phone: 213-382-8228
  • Fax: 213-382-8244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number43750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: