Basic Information
| Provider Information | |||||||||
| NPI: | 1639554439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEREZ-ALVAREZ | ||||||||
| FirstName: | INGRID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 954 1/2 COAST BLVD S | ||||||||
| Address2: | |||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920374129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865569281 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 W ARBOR DR # MC8720 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921031911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195435966 | ||||||||
| FaxNumber: | 6195433730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2015 | ||||||||
| LastUpdateDate: | 07/22/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | A128076 | CA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.