Provider Demographics
NPI:1881627743
Name:ALVAREZ, PAMELA L (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:L
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:24910 LAS BRISAS RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4010
Mailing Address - Country:US
Mailing Address - Phone:951-698-7366
Mailing Address - Fax:951-698-7367
Practice Address - Street 1:24910 LAS BRISAS RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-698-7366
Practice Address - Fax:951-698-7367
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042401207T00000X
CAA981802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH95133Medicare UPIN
WA8857425Medicare ID - Type Unspecified
CAH95133Medicare UPIN
CA8857425Medicare ID - Type Unspecified