Provider Demographics
NPI:1710736004
Name:BARNECHEA ALVARADO, NICOLAS ALONSO (MD)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:ALONSO
Last Name:BARNECHEA ALVARADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLELORD COCHRANE 347
Mailing Address - Street 2:DPTO 302
Mailing Address - City:MIRAFLORES, LIMA
Mailing Address - State:LIMA
Mailing Address - Zip Code:15073
Mailing Address - Country:PE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 W. CHARLESTON BLVD
Practice Address - Street 2:STE 230
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-676-3650
Practice Address - Fax:702-676-3635
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program