Healthcare Provider Details

I. General information

NPI: 1962008128
Provider Name (Legal Business Name): CARLOS A. ALVAREZ, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 12/11/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 SAN DIMAS ST
BAKERSFIELD CA
93301-1458
US

IV. Provider business mailing address

PO BOX 640
SHAFTER CA
93263-0640
US

V. Phone/Fax

Practice location:
  • Phone: 661-489-5999
  • Fax:
Mailing address:
  • Phone: 661-489-5999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JEANNETTE CAMACHO
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 661-978-8007