Healthcare Provider Details

I. General information

NPI: 1467730135
Provider Name (Legal Business Name): JOSE M. CHAVEZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8997 E DESERT COVE AVE FL 1
SCOTTSDALE AZ
85260-6742
US

IV. Provider business mailing address

5281 N 99TH AVE STE 100
GLENDALE AZ
85305-2209
US

V. Phone/Fax

Practice location:
  • Phone: 480-325-9600
  • Fax: 480-493-5336
Mailing address:
  • Phone: 623-516-8252
  • Fax: 623-516-8253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number006714
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number006714
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: