Provider Demographics
NPI:1043635865
Name:EBLING, ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:EBLING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5152
Mailing Address - Country:US
Mailing Address - Phone:310-737-2941
Mailing Address - Fax:310-707-4309
Practice Address - Street 1:616 VENICE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-4801
Practice Address - Country:US
Practice Address - Phone:310-737-2941
Practice Address - Fax:310-707-4309
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25431111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health