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General NPI Number Information
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NPI Number | 1730209966
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Entity Type | Organization
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Legal Business Name | CESAR T. CHAVEZ MD, INC.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 610 S 8TH ST
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City | EL CENTRO
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State | CA
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Zip | 92243-3215
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Country | US
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Telephone | 760-335-3737
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Fax | 760-335-3662
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Provider Business Mailing Address
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Address Line | PO BOX 790
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City | SOLANA BEACH
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State | CA
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Zip | 92075-0790
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Country | US
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Telephone | 858-756-2944
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Fax | 858-756-4043
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TERESA C CHAVEZ
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Credential |
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Telephone | 858-756-2944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G51615
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License Number State | CA
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