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RAFAEL UBALDO CHAVEZ PA

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1346352085

Individual Registrant:
 RAFAEL UBALDO CHAVEZ PA
Gender: M
Sole Proprietor

Location and contact information for practice:
17487 HURLEY ST  CITY OF INDUSTRY, CA 91744-5106 US
Tel: 626-965-0959  Fax: 626-912-1696

Contact information for business:
3651 AGATE WAY  WEST COVINA, CA 91792-2775 US
Tel: 626-912-1460  Fax: 626-912-1696

Registration Information:
NPI: 1346352085
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
CAPA12656

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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