Provider Demographics
NPI:1396823720
Name:VALES, ALVIN GARCIA (MD)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:GARCIA
Last Name:VALES
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 1:94-216 FARRINGTON HWY STE B2-208
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1922
Mailing Address - Country:US
Mailing Address - Phone:808-677-7500
Mailing Address - Fax:808-677-7588
Practice Address - Street 1:94-216 FARRINGTON HWY STE B2-208
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1922
Practice Address - Country:US
Practice Address - Phone:808-677-7500
Practice Address - Fax:808-677-7588
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 13722174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI169774Medicare UPIN
HI102254Medicare PIN