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General NPI Number Information
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NPI Number | 1487574406
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Entity Type | Individual
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Provider Name | JEAN VAN HORACE GOODEN ALVAREZ
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Gender | Male
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 25-1 HAMJEONG-RI, PAENGSEONG-EUP
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City | APO
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State | AP
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Zip | 96271
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Country | US
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Telephone | 825-033-3714
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Fax |
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Provider Business Mailing Address
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Address Line | 4003 KANSAS ST
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City | SAN DIEGO
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State | CA
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Zip | 92104-2507
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Country | US
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Telephone | 787-344-9753
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NA
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License Number State | FL
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