Healthcare Provider Details

I. General information

NPI: 1578931341
Provider Name (Legal Business Name): ARTURO CHAVEZ ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SCHRADER BLVD
LOS ANGELES CA
90028-6213
US

IV. Provider business mailing address

1072 S MANSFIELD AVE
LOS ANGELES CA
90019-1629
US

V. Phone/Fax

Practice location:
  • Phone: 323-993-7500
  • Fax:
Mailing address:
  • Phone: 323-979-7521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112387
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: