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NPI Code Detail

MEDICARE: DR. JOHN D. CHICO MD

MEDICARE: DR. JOHN D. CHICO MD
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
1207Q00000XFamily Medicine PhysicianA129507CA

General Provider Information

NPI Number : 1407170038
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN D. CHICO MD
Provider Business Mailing Address
First Line : 7430 E CHAPARRAL RD
Second Line : APT 201A
City : SCOTTSDALE
State : AZ
Zip : 85250-7153
Country : US
Telephone Number : 224-545-1166
Fax Number :
Provider Business Practice Location Address
First Line : 2018 MISSION ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-5218
Country : US
Telephone Number : 831-706-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2010
Last Update Date : 11/02/2021

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