MEDICARE: DR. ALFRED L HOROWITZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	G22171	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	132AT	OTHER	NC	BCBSNC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336182757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFRED L HOROWITZ M.D.

Provider Business Mailing Address
First Line	:	927 EUCLID AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94708-1449
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	927 EUCLID AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94708-1449
Country	:	US
Telephone Number	:	510-548-7634
Fax Number	:	888-633-8231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/20/2009

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