Provider Demographics
NPI:1548921349
Name:ROYBAL, ALAN JAY
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:JAY
Last Name:ROYBAL
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 1:405 S SHERIDAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3634
Mailing Address - Country:US
Mailing Address - Phone:720-586-9126
Mailing Address - Fax:
Practice Address - Street 1:405 S SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3634
Practice Address - Country:US
Practice Address - Phone:720-586-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist