Provider Demographics
NPI:1861423501
Name:ALVING, LOREN INGRID (MD)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:INGRID
Last Name:ALVING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6137 N THESTA ST
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8605
Mailing Address - Country:US
Mailing Address - Phone:559-227-4810
Mailing Address - Fax:559-227-4167
Practice Address - Street 1:6137 N THESTA ST
Practice Address - Street 2:SUITE 101B
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8605
Practice Address - Country:US
Practice Address - Phone:559-227-4810
Practice Address - Fax:559-227-4167
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG756682084N0400X, 2084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA090ZOtherPTAN
CAF45314Medicare UPIN