Healthcare Provider Details

I. General information

NPI: 1154339513
Provider Name (Legal Business Name): ALVAREZ PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 BELVEDERE WAY
CORONA CA
92882-6325
US

IV. Provider business mailing address

3506 BELVEDERE WAY
CORONA CA
92882-6325
US

V. Phone/Fax

Practice location:
  • Phone: 951-735-7815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20785
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7178
License Number StateCA

VIII. Authorized Official

Name: RAMIL ALVAREZ
Title or Position: OWNER
Credential:
Phone: 951-735-7815