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 |
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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 |
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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 |
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Provider Enumeration Date | 03/06/2013 |
Last Update Date | 06/03/2013 |
Medicare PECOS PAC ID | 0345479820 |
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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 |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417030222 PECOS PAC ID: 8123010691 Enrollment ID: I20040402000531 |
Provider Name | Tanya Bengali |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548508930 PECOS PAC ID: 8820242670 Enrollment ID: I20170825001112 |
Provider Name | Christine E Musich |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760014724 PECOS PAC ID: 2264852862 Enrollment ID: I20201021000545 |
Provider Name | Lynnezy Laurencin |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1619354297 PECOS PAC ID: 0648653980 Enrollment ID: I20220818001858 |
Provider Name | Gabriela Villafuerte |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659020550 PECOS PAC ID: 4587009766 Enrollment ID: I20240227003659 |
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