Healthcare Provider Details

I. General information

NPI: 1861423501
Provider Name (Legal Business Name): LOREN INGRID ALVING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 11/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6137 N THESTA ST SUITE 101B
FRESNO CA
93710-8605
US

IV. Provider business mailing address

6137 N THESTA ST SUITE 101B
FRESNO CA
93710-8605
US

V. Phone/Fax

Practice location:
  • Phone: 559-227-4810
  • Fax: 559-227-4167
Mailing address:
  • Phone: 559-227-4810
  • Fax: 559-227-4167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG75668
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberG75668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: