Healthcare Provider Details

I. General information

NPI: 1790525020
Provider Name (Legal Business Name): EMILIANO CHAVIRA MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15141 WHITTIER BLVD STE 200
WHITTIER CA
90603-2173
US

IV. Provider business mailing address

15141 WHITTIER BLVD STE 200
WHITTIER CA
90603-2173
US

V. Phone/Fax

Practice location:
  • Phone: 562-414-4600
  • Fax: 562-267-5872
Mailing address:
  • Phone: 562-414-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILIANO R CHAVIRA
Title or Position: OWNER
Credential: MD
Phone: 562-414-4600