Provider Demographics
NPI:1609687805
Name:ALCALA, CHRISTIAN IVAN
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:IVAN
Last Name:ALCALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 PLANZ RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-6105
Mailing Address - Country:US
Mailing Address - Phone:858-281-8688
Mailing Address - Fax:
Practice Address - Street 1:1016 PLANZ RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-6105
Practice Address - Country:US
Practice Address - Phone:858-281-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program