Healthcare Provider Details

I. General information

NPI: 1649352626
Provider Name (Legal Business Name): RICARDO ALVAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 SHOTWELL ST
SAN FRANCISCO CA
94110-1323
US

IV. Provider business mailing address

240 SHOTWELL ST
SAN FRANCISCO CA
94110-1323
US

V. Phone/Fax

Practice location:
  • Phone: 415-552-1013
  • Fax: 415-552-2902
Mailing address:
  • Phone: 415-552-1013
  • Fax: 415-552-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberG73709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: