MEDICARE: MR. URIEL DIAZ-CHAVEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1003151192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. URIEL DIAZ-CHAVEZ

Provider Business Mailing Address
First Line	:	2300 DICKERSON RD APT 65
Second Line	:	2300 DICKERSON #65
City	:	RENO
State	:	NV
Zip	:	89503-4923
Country	:	US
Telephone Number	:	775-229-5945
Fax Number	:	775-420-5053

Provider Business Practice Location Address
First Line	:	2300 DICKERSON RD APT 65
Second Line	:	2300 DICKERSON #65
City	:	RENO
State	:	NV
Zip	:	89503-4923
Country	:	US
Telephone Number	:	775-229-5945
Fax Number	:	775-420-5053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2012
Last Update Date	:	11/30/2012

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Directions to “ MR. URIEL DIAZ-CHAVEZ ” Practice Location

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