1851378392

Everything you always wanted to know about ENGWALL ALAN SCOTT MD but were afraid to ask.

ENGWALL ALAN SCOTT MD

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
ENGWALL ALAN SCOTT MD
Gender:
Male
Enumeration date:
2005-12-27
Last update date:
2008-02-14
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
00G642110 Medicaid none CA
WG64211B Medicare PIN none CA
00G642111 Medicare ID-Type Undpecified none none
00G642110 Other BLUE SHIELD none
E72125 Medicare UPIN none none

Taxonomies

Taxonomy State License Number Primary?
207L00000X Anesthesiology CA G64211

Phone Numbers

Type Number
Mailing Address Telephone Number 7144566369
Practice Location Address Telephone Number 7144568978

Addresses

Type Address City State Postal Country
Mailing Address PO BOX 54330 UCI MEDICAL CENTER LOS ANGELES CA 90054 CA
Practice Location Address 101 THE CITY DRIVE SOUTH UNV ANESTHESIA ASSOCIATES ORANGE CA 92868 CA

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