=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881627743
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA L. ALVAREZ M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2006
-----------------------------------------------------
Last Update Date | 09/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24910 LAS BRISAS RD SUITE 115
-----------------------------------------------------
City | MURRIETA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92562
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-698-7366
-----------------------------------------------------
Fax | 951-698-7367
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24910 LAS BRISAS RD SUITE 115
-----------------------------------------------------
City | MURRIETA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92562-4010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-698-7366
-----------------------------------------------------
Fax | 951-698-7367
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207T00000X
-----------------------------------------------------
Taxonomy Name | Neurological Surgery Physician
-----------------------------------------------------
License Number | MD00042401
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | A98180
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------