Provider Demographics
NPI:1134585664
Name:ALVAREZ, LORENZO (PHARMD)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 GENEVA WAY
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-6657
Mailing Address - Country:US
Mailing Address - Phone:650-400-0363
Mailing Address - Fax:
Practice Address - Street 1:2012 GENEVA WAY
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-6657
Practice Address - Country:US
Practice Address - Phone:650-400-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist