Healthcare Provider Details

I. General information

NPI: 1124997424
Provider Name (Legal Business Name): DOMINIC BATTUNG ALVAREZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25919 GADING RD
HAYWARD CA
94544-2725
US

IV. Provider business mailing address

3562 CATTAIL CT
UNION CITY CA
94587-1740
US

V. Phone/Fax

Practice location:
  • Phone: 510-782-8424
  • Fax:
Mailing address:
  • Phone: 510-600-4174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: