Juan Elmer Alvarado, PA-C
Individual provider Active NPI Surgical Physician Assistant · Norwalk, CA
NPI 1285963678 · NPPES record last updated Apr 20, 2011
Key facts
- NPI
- 1285963678
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA20496 (CA)
- Practice address
- 10924 Hoback St
Norwalk, CA 90650-3553 - Phone
- (562) 929-7420
- NPI assigned
- Dec 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111101000337 | CA | Practitioner - Physician Assistant | 0547433989 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20496 | CA | MD | Clinical Child & Adolescent Psychologist |
| PA20496 | CA | MD | General Acute Care Hospital |
Interoperability endpoints
- jalvarado861802@direct.memorialcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA20496 | CA | Yes |
| General Acute Care Hospital | 282N00000X | PA20496 | CA |
Addresses
Primary practice location
10924 Hoback St
Norwalk, CA 90650-3553
Mailing address
10924 Hoback St
Norwalk, CA 90650-3553
Phone (562) 929-7420
Other providers in Norwalk, CA
- Marissa Alonso
- Alphacare Health Providers Inc.
- Altamed Health Services Corp
- Amaogechukwu Assumpta Alugbue
- Alvand Zinabadi DDS Inc
- Alicia Alvarez
- Amy Alvarez
- Martin Alvarez
- Jocelyn Amador
- Jaydina D Amaker
All providers in Norwalk, CA · Surgical Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.