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General NPI Number Information
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NPI Number | 1891379673
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Entity Type | Individual
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Provider Name | JERALD CHAVEZ DC
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Gender | Male
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Dates
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Enumeration Date | 05/08/2021
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Last Update Date | 05/08/2021
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Provider Practice Location Address
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Address Line | 444 WESTLAKE CTR
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City | DALY CITY
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State | CA
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Zip | 94015-1432
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Country | US
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Telephone | 415-915-1027
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Fax |
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Provider Business Mailing Address
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Address Line | 4502 VIA LA PAZ
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City | UNION CITY
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State | CA
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Zip | 94587-3858
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 35009
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License Number State | CA
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