Provider Demographics
NPI:1154594885
Name:IKEDA, ALAN K (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:K
Last Name:IKEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11700 W CHARLESTON BLVD # 170-165
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1573
Mailing Address - Country:US
Mailing Address - Phone:808-852-2487
Mailing Address - Fax:
Practice Address - Street 1:3087 E WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3753
Practice Address - Country:US
Practice Address - Phone:702-463-1011
Practice Address - Fax:702-463-1219
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA919142080P0207X, 208000000X
HI239612080P0207X, 208000000X
NV136202080P0207X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics