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General NPI Number Information
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NPI Number | 1568481679
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Entity Type | Organization
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Legal Business Name | LUIS A CHANES M D INC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 2621 S BRISTOL ST SUITE 205
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City | SANTA ANA
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State | CA
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Zip | 92704-5766
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Country | US
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Telephone | 714-557-5777
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Fax | 714-557-7710
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Provider Business Mailing Address
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Address Line | 2621 S BRISTOL ST SUITE 205
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City | SANTA ANA
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State | CA
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Zip | 92704-5766
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Country | US
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Telephone | 714-557-5777
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Fax | 714-557-7710
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LUIS ALBERTO CHANES
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Credential | M.D.
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Telephone | 714-557-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G73198
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License Number State | CA
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