Provider Demographics
NPI:1154697126
Name:POCHOWSKI, ALAN HOLDEN (PA-C)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:HOLDEN
Last Name:POCHOWSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 S EASTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7851
Mailing Address - Country:US
Mailing Address - Phone:702-735-1556
Mailing Address - Fax:702-737-7495
Practice Address - Street 1:4445 S EASTERN AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7851
Practice Address - Country:US
Practice Address - Phone:702-735-1556
Practice Address - Fax:702-737-7495
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1343363AM0700X
AZ5124363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV35664OtherMEDICARE GROUP PTAN
AZP01078090OtherRR MEDICARE INDIV. PTAN
AZZ152823Medicare PIN
AZDC1553OtherRR MEDICARE GROUP PTAN
AZZ35713OtherGROUP PTAN
NVGG5232Medicare PIN