Provider Demographics
NPI:1639110679
Name:ALVAREZ, SAUL (RRT RPSGT)
Entity type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:RRT RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 MESQUITE AVE
Mailing Address - Street 2:#201
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403
Mailing Address - Country:US
Mailing Address - Phone:928-855-7570
Mailing Address - Fax:928-855-7574
Practice Address - Street 1:1720 MESQUITE AVE
Practice Address - Street 2:#201
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403
Practice Address - Country:US
Practice Address - Phone:928-855-7570
Practice Address - Fax:928-855-7574
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01398227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ881525Medicaid
AZ881525Medicaid