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NPI Code Detail

MEDICARE: ALEXIS VICTORIA CHAET-LOPEZ MD

MEDICARE: ALEXIS VICTORIA CHAET-LOPEZ 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 PhysicianMD61535631WA
2207Q00000XFamily Medicine PhysicianA182915CA

General Provider Information

NPI Number : 1457928012
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS VICTORIA CHAET-LOPEZ MD
Provider Business Mailing Address
First Line : 120 STONY POINT RD STE 120
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4154
Country : US
Telephone Number : 707-387-3212
Fax Number :
Provider Business Practice Location Address
First Line : 751 LOMBARDI CT
Second Line :
City : SANTA ROSA
State : CA
Zip : 95407-6798
Country : US
Telephone Number : 707-303-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2021
Last Update Date : 12/10/2025

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Directions to “ ALEXIS VICTORIA CHAET-LOPEZ MD” Practice Location

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