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JOSE CARLOS CHAVEZ

Ambulatory Health Care Facilities Clinic/Center Public Health, State or Local

Provider NPI: 1447394531

Organization Information:
Organization Name:  JOSE CARLOS CHAVEZ
Organization is not Subpart
Authorized Official:  JOSE CARLOS CHAVEZ  NURSE PRACTITIONER  951-924-5023

Practice Location:
17299 CREMELLO WAY  MORENO VALLEY, CA 92555 US
Tel: 951-924-5023  Fax: --

Business Mailing Address:
17299 CREMELLO WAY NA MORENO VALLEY, CA 92555 US
Tel: 951-924-5023  Fax: --

NPI Information:
NPI: 1447394531
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QP0905XAmbulatory Health Care Facilities
Clinic/Center
Public Health, State or Local
CA14641

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 261QP0905X

Type:

Classification:



Definition:



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