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General NPI Number Information
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NPI Number | 1144376435
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Entity Type | Organization
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Legal Business Name | PACIFIC NEUROPSYCHIATRIC SPECIALISTS
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 3151 AIRWAY AVE STE T3
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City | COSTA MESA
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State | CA
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Zip | 92626-4627
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Country | US
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Telephone | 949-545-5550
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Fax | 949-545-5748
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Provider Business Mailing Address
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Address Line | 3151 AIRWAY AVE STE T3
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City | COSTA MESA
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State | CA
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Zip | 92626-4627
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Country | US
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Telephone | 949-545-5550
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Fax | 949-545-5748
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEJANDRO ALVA
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Credential | M.D.
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Telephone | 949-545-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A062396
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License Number State | CA
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