MEDICARE: DR. LUCIA MIRELES-CHAVEZ M.D.

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	208000000X	Pediatrics Physician	A71537	CA

General Provider Information

NPI Number	:	1457322067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCIA MIRELES-CHAVEZ M.D.

Provider Business Mailing Address
First Line	:	7206 N MILBURN AVE STE 106
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8450
Country	:	US
Telephone Number	:	559-840-0066
Fax Number	:	559-272-0479

Provider Business Practice Location Address
First Line	:	7206 N MILBURN AVE STE 106
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8450
Country	:	US
Telephone Number	:	559-840-0066
Fax Number	:	559-272-0479

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	11/05/2022

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