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NPI Code Detail

MEDICARE: JOSE ANGEL CHAVEZ BA

MEDICARE: JOSE ANGEL CHAVEZ BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1073624193
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE ANGEL CHAVEZ BA
Provider Business Mailing Address
First Line : 1011 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3567
Country : US
Telephone Number : 619-287-8225
Fax Number : 619-393-0386
Provider Business Practice Location Address
First Line : 1011 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3567
Country : US
Telephone Number : 619-287-8225
Fax Number : 619-393-0386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 03/27/2025

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Directions to “ JOSE ANGEL CHAVEZ BA” Practice Location

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