Provider Demographics
NPI:1063942530
Name:ALVAREZ, REGINA (RDA)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 N LOS COYOTES DIAGONAL STE 200
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3938
Mailing Address - Country:US
Mailing Address - Phone:562-377-1375
Mailing Address - Fax:
Practice Address - Street 1:3320 N LOS COYOTES DIAGONAL STE 200
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3938
Practice Address - Country:US
Practice Address - Phone:562-377-1375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant