Healthcare Provider Details

I. General information

NPI: 1316617202
Provider Name (Legal Business Name): ALEJANDRO ALVARADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 S FAIR OAKS AVE STE 110
PASADENA CA
91105-2614
US

IV. Provider business mailing address

23456 HAWTHORNE BLVD #200
TORRANCE CA
90505
US

V. Phone/Fax

Practice location:
  • Phone: 818-369-7620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT300644
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: