Individual
ALAN C. WESTEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16486 BERNARDO CENTER DR, SUITE C-150, SAN DIEGO, CA 92128-2518
(858) 673-2277
(858) 451-3733
Mailing address
4629 CASS ST, #59, SAN DIEGO, CA 92109-2805
(858) 673-2277
(858) 451-3733
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G79738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G797380
—
CA
01
—
11179547
CAQH PROVIDER ID#
CA
01
—
G79738
CA STATE MEDICAL LICENSE#
CA
01
—
MD-072371-L
PA STATE MEDICAL LICENSE#
PA
Enumeration date
08/31/2006
Last updated
10/21/2009
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