Provider Demographics
NPI:1639554439
Name:PEREZ-ALVAREZ, INGRID (MD)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:PEREZ-ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 1/2 COAST BLVD S
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4129
Mailing Address - Country:US
Mailing Address - Phone:786-556-9281
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR # MC8720
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1911
Practice Address - Country:US
Practice Address - Phone:619-543-5966
Practice Address - Fax:619-543-3730
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128076207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology