Provider Demographics
NPI:1477729150
Name:ALVAREZ, CHRISTIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HODENCAMP RD STE 103
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5831
Mailing Address - Country:US
Mailing Address - Phone:805-777-7003
Mailing Address - Fax:805-777-7043
Practice Address - Street 1:101 HODENCAMP RD
Practice Address - Street 2:SUITE #103
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5836
Practice Address - Country:US
Practice Address - Phone:805-777-7003
Practice Address - Fax:805-777-7043
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26007111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16125Medicare PIN
CAU93258Medicare UPIN