Basic Information
| Provider Information | |||||||||
| NPI: | 1851671903 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVES | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | PETER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 38 DUDLEY AVE APT A | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902912405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105606243 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6842 VAN NUYS BLVD | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914054650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014830 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2011 | ||||||||
| LastUpdateDate: | 08/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.