Healthcare Provider Details

I. General information

NPI: 1801816764
Provider Name (Legal Business Name): ALEJANDRO ALVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 AIRWAY AVE STE G1
COSTA MESA CA
92626-4624
US

IV. Provider business mailing address

3151 AIRWAY AVE STE G1
COSTA MESA CA
92626-4624
US

V. Phone/Fax

Practice location:
  • Phone: 714-545-5550
  • Fax: 714-708-2588
Mailing address:
  • Phone: 714-545-5550
  • Fax: 714-708-2588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA062396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: