Basic Information
| Provider Information | |||||||||
| NPI: | 1134145527 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DENNIS B. ALTERS, MD, A PROFESSIONAL CORPORATION | ||||||||
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| OtherOrganizationName: | DENNIS B. ALTERS, MD, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2125 S EL CAMINO REAL | ||||||||
| Address2: | SUITE #104 | ||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920546260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609675898 | ||||||||
| FaxNumber: | 7609676042 | ||||||||
| Practice Location | |||||||||
| Address1: | 2125 S EL CAMINO REAL | ||||||||
| Address2: | SUITE #104 | ||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920546260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609675898 | ||||||||
| FaxNumber: | 7609676042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 02/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | ALTERS | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
| AuthorizedOfficialMiddleName: | B. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7609675898 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | G36206 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 2084P0800X | G36206 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.