Healthcare Provider Details

I. General information

NPI: 1437167582
Provider Name (Legal Business Name): FERNAND RENE ALVAREZ III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20730 VALLEY GREEN DR
CUPERTINO CA
95014-1704
US

IV. Provider business mailing address

20730 VALLEY GREEN DR
CUPERTINO CA
95014-1704
US

V. Phone/Fax

Practice location:
  • Phone: 408-783-4000
  • Fax:
Mailing address:
  • Phone: 408-783-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA73979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: