Provider Demographics
NPI:1104937523
Name:SHATZEL, ALAN (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:SHATZEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A76722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2238062OtherFIRST HEALTH
CA106608OtherHEALTH NET
CA1851092OtherGREAT WEST
CAMCMG358800OtherWESTERN HEALTH ADVANTAGE
CA20A7672OtherBLUE CROSS
CA237354OtherINTERPLAN
CA000810614181OtherPHCS
CA2464530OtherUNITED HEALTHCARE
CA7550598OtherAETNA
CA00AX76720Medicaid
CA8344837OtherCIGNA
CA90143537OtherPACIFICARE
CA20A7672OtherBLUE CROSS
CA00AX76720Medicaid