Provider Demographics
NPI:1144376435
Name:PACIFIC NEUROPSYCHIATRIC SPECIALISTS
Entity Type:Organization
Organization Name:PACIFIC NEUROPSYCHIATRIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-545-5550
Mailing Address - Street 1:3151 AIRWAY AVE STE T3
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4627
Mailing Address - Country:US
Mailing Address - Phone:949-545-5550
Mailing Address - Fax:949-545-5748
Practice Address - Street 1:3151 AIRWAY AVE STE T3
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4627
Practice Address - Country:US
Practice Address - Phone:949-545-5550
Practice Address - Fax:949-545-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0623962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty