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General NPI Number Information
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NPI Number | 1245561752
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Entity Type | Organization
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Legal Business Name | ELISA C ALVARADO MD INC
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 630 S RAYMOND AVE SUITE 340
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-584-0026
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Fax | 626-584-6166
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Provider Business Mailing Address
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Address Line | 630 S RAYMOND AVE SUITE 340
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-584-0026
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Fax | 626-584-6166
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELISA C ALVARADO
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Credential | M.D.
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Telephone | 626-584-0026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A98438
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License Number State | CA
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