Healthcare Provider Details

I. General information

NPI: 1093115149
Provider Name (Legal Business Name): ROBERT ANTHONY CHAVARIN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK PLZ STE 600
IRVINE CA
92614-5987
US

IV. Provider business mailing address

1 PARK PLZ STE 600
IRVINE CA
92614-5987
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-7300
  • Fax:
Mailing address:
  • Phone: 949-515-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number51845
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0007786
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: