Healthcare Provider Details
I. General information
NPI: 1558342717
Provider Name (Legal Business Name): CARLOS M ALVES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/07/2005
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 16TH AVE E
SEATTLE WA
98112-5226
US
IV. Provider business mailing address
501 I SOUTH REINO ROAD SUITE 391
NEWBURY PARK CA
91320-4268
US
V. Phone/Fax
- Phone: 206-326-3000
- Fax: 877-515-2975
- Phone: 805-768-4198
- Fax: 877-794-1288
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | C54056 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | MD61560544 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: