Provider Demographics
NPI:1558342717
Name:ALVES, CARLOS M (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:M
Last Name:ALVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:501 I SOUTH REINO ROAD
Mailing Address - Street 2:SUITE 391
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4268
Mailing Address - Country:US
Mailing Address - Phone:805-768-4198
Mailing Address - Fax:877-794-1288
Practice Address - Street 1:2220 LYNN ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1904
Practice Address - Country:US
Practice Address - Phone:805-768-4198
Practice Address - Fax:877-794-1288
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2012-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC54056207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI143936Medicare UPIN