MEDICARE: LUIS ARTURO ALVARADO DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	35833	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000135833CA	OTHER	CA	DELTA DENTAL
2	B3583301	OTHER	CA	DENTICAL
3	B3583304	OTHER	CA	DENTICAL
4	B3583303	OTHER	CA	DENTICAL
5	000235833CA	OTHER	CA	DELTA DENTAL

General Provider Information

NPI Number	:	1447307681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUIS ARTURO ALVARADO DDS INC

Provider Business Mailing Address
First Line	:	3936 MAINE AVE
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-4220
Country	:	US
Telephone Number	:	626-856-3456
Fax Number	:	626-856-1183

Provider Business Practice Location Address
First Line	:	3936 MAINE AVE
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-4220
Country	:	US
Telephone Number	:	626-856-3456
Fax Number	:	626-856-1183

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. LUIS S ALVARADO
Credential	:	D.D.S
Telephone Number	:	626-856-3456

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	10/31/2018

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