Provider Demographics
NPI:1114147212
Name:ALVARADO, FRANK SILVIO (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:SILVIO
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2450
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95241-2450
Mailing Address - Country:US
Mailing Address - Phone:209-333-7540
Mailing Address - Fax:209-333-7444
Practice Address - Street 1:830 S HAM LANE
Practice Address - Street 2:SUITE 30
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240
Practice Address - Country:US
Practice Address - Phone:209-333-7540
Practice Address - Fax:209-333-7444
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA042153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A421530Medicaid
A29520Medicare UPIN
00A421530Medicare ID - Type Unspecified