Healthcare Provider Details

I. General information

NPI: 1740758416
Provider Name (Legal Business Name): SILVERIO DE JESUS ALVAREZ M.S., M.H.S., PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2018
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

552 S PASEO DOROTEA STE 2
PALM SPRINGS CA
92264-1437
US

IV. Provider business mailing address

81767 DR CARREON BLVD STE 201
INDIO CA
92201-5599
US

V. Phone/Fax

Practice location:
  • Phone: 760-320-6988
  • Fax: 760-320-9796
Mailing address:
  • Phone: 760-775-4181
  • Fax: 760-775-4818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA56284
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: