Provider Demographics
NPI:1861031353
Name:TOVAR, ALEX
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:TOVAR
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 1:16901 CLEMENTINE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-6935
Mailing Address - Country:US
Mailing Address - Phone:949-350-7505
Mailing Address - Fax:
Practice Address - Street 1:16901 CLEMENTINE CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-6935
Practice Address - Country:US
Practice Address - Phone:949-350-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program