Healthcare Provider Details

I. General information

NPI: 1225180540
Provider Name (Legal Business Name): SANTIAGO ALVAREZ HMD. RCP.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22635 ALESSANDRO BLVD SUITE B
MORENO VALLEY CA
92553-8550
US

IV. Provider business mailing address

22635 ALESSANDRO BLVD SUITE B
MORENO VALLEY CA
92553-8550
US

V. Phone/Fax

Practice location:
  • Phone: 951-653-5300
  • Fax: 951-653-5346
Mailing address:
  • Phone: 951-653-5300
  • Fax: 951-653-5346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License NumberRCP12108
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2278P1006X
TaxonomyPulmonary Function Technologist Certified Respiratory Therapist
License Number12108
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierRCP 12108
Identifier TypeOTHER
Identifier StateCA
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: