Provider Demographics
NPI:1164252003
Name:ALVAREZ, RAMIRO ADRIAN (DA)
Entity type:Individual
Prefix:
First Name:RAMIRO
Middle Name:ADRIAN
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 47TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4735
Mailing Address - Country:US
Mailing Address - Phone:619-618-6309
Mailing Address - Fax:
Practice Address - Street 1:1539 E PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3641
Practice Address - Country:US
Practice Address - Phone:866-319-9409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant