Provider Demographics
NPI:1124009923
Name:ALVIDREZ, VIRGINIA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:ALVIDREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 Q STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1645
Mailing Address - Country:US
Mailing Address - Phone:661-323-5918
Mailing Address - Fax:661-323-4703
Practice Address - Street 1:101 ADKISSON WAY
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3602
Practice Address - Country:US
Practice Address - Phone:661-765-1935
Practice Address - Fax:661-765-1928
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00228421OtherRAILROAD MEDICARE
CA00A877590Medicaid
CAP00228421OtherRAILROAD MEDICARE
CA00A877590Medicaid