Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A173630 | CA |
NPI | 1003303850 |
---|---|
Provider Name | Alexa Chavez |
First Address | Monte Sereno, CA 95030-2235 |
Second Address | La Jolla, CA 92037-1300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 12/09/2021 |