Provider Demographics
NPI:1588755052
Name:SLOAN, ALFRED W (MD)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:W
Last Name:SLOAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 N ROSE DR STE 122
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3919
Mailing Address - Country:US
Mailing Address - Phone:714-961-0808
Mailing Address - Fax:714-961-0115
Practice Address - Street 1:1275 N ROSE DR STE 122
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3919
Practice Address - Country:US
Practice Address - Phone:714-961-0808
Practice Address - Fax:714-961-0115
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45139207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G45139Medicaid
CAA92553Medicare UPIN
CAG45139AMedicare ID - Type UnspecifiedMEDICARE #