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NPI Code Detail

MEDICARE: MARTHA ALICIA CHAVEZ-RANGEL FNP

MEDICARE: MARTHA ALICIA CHAVEZ-RANGEL FNP
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
1363L00000XNurse Practitioner95027488CA

General Provider Information

NPI Number : 1073384608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA ALICIA CHAVEZ-RANGEL FNP
Provider Business Mailing Address
First Line : 510 S ALVARADO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2904
Country : US
Telephone Number : 213-483-3600
Fax Number :
Provider Business Practice Location Address
First Line : 1711 W KATELLA AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92804-6450
Country : US
Telephone Number : 714-400-2959
Fax Number : 714-253-3506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2024
Last Update Date : 03/17/2025

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