Healthcare Provider Details

I. General information

NPI: 1396772844
Provider Name (Legal Business Name): PATRICIA M ALVARADO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 W BEVERLY BLVD
MONTEBELLO CA
90640-2217
US

IV. Provider business mailing address

3114 W BEVERLY BLVD
MONTEBELLO CA
90640-2217
US

V. Phone/Fax

Practice location:
  • Phone: 323-726-3868
  • Fax: 323-726-3870
Mailing address:
  • Phone: 323-726-3868
  • Fax: 323-726-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA44552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: