Basic Information
| Provider Information | |||||||||
| NPI: | 1396185617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | OSCAR | ||||||||
| MiddleName: | EDUARDO | ||||||||
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| Credential: | IBCLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 368 S FORD BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900221806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3239809644 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1300 N VERMONT AVE | ||||||||
| Address2: | PATIENT TOWER 1ST FLOOR | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900276005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234546940 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2013 | ||||||||
| LastUpdateDate: | 05/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174N00000X | 11177518 | CA | Y | Other Service Providers | Lactation Consultant, Non-RN |
No ID Information.