Provider Demographics
NPI:1851084479
Name:ALVARADO, ROD SOMERA
Entity Type:Individual
Prefix:
First Name:ROD
Middle Name:SOMERA
Last Name:ALVARADO
Suffix:
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 1:9252 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6371
Mailing Address - Country:US
Mailing Address - Phone:714-699-1011
Mailing Address - Fax:
Practice Address - Street 1:9252 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6371
Practice Address - Country:US
Practice Address - Phone:714-699-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility