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General NPI Number Information
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NPI Number | 1972290526
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Entity Type | Individual
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Provider Name | ALVARO PINILLA PA
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Gender | Male
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1141 E GLENDALE AVE
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City | PHOENIX
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State | AZ
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Zip | 85020-5316
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Country | US
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Telephone | 328-186-2478
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Fax | 602-229-8560
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Provider Business Mailing Address
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Address Line | 636 W SOUTHERN AVE
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City | MESA
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State | AZ
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Zip | 85210-5005
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Country | US
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Telephone | 832-818-6247
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10333
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1636-P-A
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License Number State | PR
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