Provider Demographics
NPI:1518269067
Name:TUCHAN, ALVARO HUMBERTO JR
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:HUMBERTO
Last Name:TUCHAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15370 WEDDINGTON ST APT 218
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3829
Mailing Address - Country:US
Mailing Address - Phone:323-719-5178
Mailing Address - Fax:
Practice Address - Street 1:15370 WEDDINGTON ST APT 218
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-3829
Practice Address - Country:US
Practice Address - Phone:323-719-5178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014340-1363A00000X
CA56828363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant