Provider Demographics
NPI:1790833119
Name:ALVAREZ-MARTINEZ, LILIANA (MD)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:ALVAREZ-MARTINEZ
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 1:727 W SAN MARCOS BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-1244
Mailing Address - Country:US
Mailing Address - Phone:760-736-8810
Mailing Address - Fax:760-736-3157
Practice Address - Street 1:727 W SAN MARCOS BLVD STE 112
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1244
Practice Address - Country:US
Practice Address - Phone:760-736-8810
Practice Address - Fax:760-736-3157
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A937970Medicaid
CA00A937970Medicaid
CA00A937970Medicare PIN
CA00A937972Medicare PIN
CA00A937971Medicare PIN