MEDICARE: JUAN A ALVARADO P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA13827	CA

General Provider Information

NPI Number	:	1780771659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN A ALVARADO P.A.

Provider Business Mailing Address
First Line	:	2935 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1528
Country	:	US
Telephone Number	:	323-526-9770
Fax Number	:	323-526-4646

Provider Business Practice Location Address
First Line	:	2935 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1528
Country	:	US
Telephone Number	:	323-526-9770
Fax Number	:	323-526-4646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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