Basic Information
| Provider Information | |||||||||
| NPI: | 1659787174 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | CLAUDIA | ||||||||
| MiddleName: | ALEJANDRA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1403 LOMITA BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HARBOR CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907102086 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105347600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1403 LOMITA BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HARBOR CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907102086 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105347600 | ||||||||
| FaxNumber: | 3103267205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2014 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS15660 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 102377500 | 05 | FL | MEDICAID |