Healthcare Provider Details

I. General information

NPI: 1427096569
Provider Name (Legal Business Name): ISRAEL J ALVARADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 MCDANIEL ST STE 250
NORTH LAS VEGAS NV
89030-6309
US

IV. Provider business mailing address

2031 MCDANIEL ST STE 250
NORTH LAS VEGAS NV
89030-6309
US

V. Phone/Fax

Practice location:
  • Phone: 702-649-9070
  • Fax: 702-649-9080
Mailing address:
  • Phone: 702-649-9070
  • Fax: 702-649-9080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number11299
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11299
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: