Healthcare Provider Details

I. General information

NPI: 1558803999
Provider Name (Legal Business Name): MARITZA ALVARADO MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARITZA ALVARADO MAUE MD PHD

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 E CESAR E CHAVEZ AVE
LOS ANGELES CA
90033-2414
US

IV. Provider business mailing address

17284 SLOVER AVE STE 205
FONTANA CA
92337-7584
US

V. Phone/Fax

Practice location:
  • Phone: 323-260-5789
  • Fax:
Mailing address:
  • Phone: 833-574-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA151393
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.MD.70009627
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: