Provider Demographics
NPI:1578398939
Name:ALVAREZ, ANDRES (RN)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-2936
Mailing Address - Country:US
Mailing Address - Phone:626-354-0017
Mailing Address - Fax:
Practice Address - Street 1:4136 MONTEREY AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-2936
Practice Address - Country:US
Practice Address - Phone:626-354-0017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035465163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse