| Gustavo Alva, M.d., A Professional Corporation | |
|
3151 Airway Ave Suite T3 Costa Mesa CA 92626-4627 | |
| (714) 545-5550 | |
| (714) 545-5748 |
| Full Name | Gustavo Alva, M.d., A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3151 Airway Ave, Costa Mesa, California |
| Authorized Official Name and Position | Gustavo Alva (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 7145455550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo Alva, M.d., A Professional Corporation 3151 Airway Ave Suite T3 Costa Mesa CA 92626-4627 Ph: (714) 545-5550 | Gustavo Alva, M.d., A Professional Corporation 3151 Airway Ave Suite T3 Costa Mesa CA 92626-4627 Ph: (714) 545-5550 |
| NPI Number | 1376884072 |
|---|---|
| Provider Enumeration Date | 03/06/2013 |
| Last Update Date | 06/03/2013 |
| Medicare PECOS PAC ID | 0345479820 |
|---|---|
| Medicare Enrollment ID | O20140203000662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376884072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Gustavo Alva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417030222 PECOS PAC ID: 8123010691 Enrollment ID: I20040402000531 |
| Provider Name | Tanya Bengali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548508930 PECOS PAC ID: 8820242670 Enrollment ID: I20170825001112 |
| Provider Name | Christine E Musich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760014724 PECOS PAC ID: 2264852862 Enrollment ID: I20201021000545 |
| Provider Name | Lynnezy Laurencin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619354297 PECOS PAC ID: 0648653980 Enrollment ID: I20220818001858 |
| Provider Name | Gabriela Villafuerte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659020550 PECOS PAC ID: 4587009766 Enrollment ID: I20240227003659 |
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