Healthcare Provider Details

I. General information

NPI: 1265468946
Provider Name (Legal Business Name): ALVARADO HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 ALVARADO RD
SAN DIEGO CA
92120-5208
US

IV. Provider business mailing address

6655 ALVARADO RD
SAN DIEGO CA
92120-5208
US

V. Phone/Fax

Practice location:
  • Phone: 619-229-3172
  • Fax: 619-229-3273
Mailing address:
  • Phone: 619-229-3172
  • Fax: 619-229-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number090000013
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberHSP48400
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER DOAN
Title or Position: CHIEF COMPLIANCE COUNSEL
Credential:
Phone: 909-235-4307