1245601285 NPI number — CARLOS A. ALVAREZ, M.D., INC

Table of content: (NPI 1245601285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245601285 NPI number — CARLOS A. ALVAREZ, M.D., INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARLOS A. ALVAREZ, M.D., INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245601285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 640
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHAFTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93263-0640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-473-1753
Provider Business Mailing Address Fax Number:
866-547-8781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8929 PANAMA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93241-1647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-473-1753
Provider Business Practice Location Address Fax Number:
866-547-8781
Provider Enumeration Date:
10/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ALVAREZ
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
661-746-7244

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A042986 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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