Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A91914 | CA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 13620 | NV |
N | 2080P0207X | Pediatric Hematology-Oncologist | A91914 | CA |
NPI | 1154594885 |
---|---|
Provider Name | Dr. Alan K Ikeda |
First Address | Las Vegas, NV 89147-8465 |
Second Address | Las Vegas, NV 89135-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 19/10/2020 |