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NPI Code Detail

MEDICARE: DR. PATRICK DARIN CHIAVAROLI D.C.

MEDICARE: DR. PATRICK DARIN CHIAVAROLI D.C.
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
1111NS0005XSports Physician Chiropractor5738AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0245430OTHERAZBCBS PROVIDER #

General Provider Information

NPI Number : 1093778060
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK DARIN CHIAVAROLI D.C.
Provider Business Mailing Address
First Line : 4646 E GREENWAY RD
Second Line : SUITE 104
City : PHOENIX
State : AZ
Zip : 85032-4805
Country : US
Telephone Number : 602-867-1444
Fax Number : 602-867-7255
Provider Business Practice Location Address
First Line : 4646 E GREENWAY RD
Second Line : SUITE 104
City : PHOENIX
State : AZ
Zip : 85032-4805
Country : US
Telephone Number : 602-867-1444
Fax Number : 602-867-7255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/08/2007

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