Provider Demographics
NPI:1104048586
Name:NAZAR, ALEX (DC DOCTOR OF CHIROPR)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:NAZAR
Suffix:
Gender:M
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 573425
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91357-3425
Mailing Address - Country:US
Mailing Address - Phone:818-404-8249
Mailing Address - Fax:
Practice Address - Street 1:19100 VENTURA BLVD STE 14
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3234
Practice Address - Country:US
Practice Address - Phone:818-404-8249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24530AMedicare ID - Type Unspecified
CADC24530Medicare ID - Type Unspecified