Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC-30888 | CA |
NPI | 1003044579 |
---|---|
Provider Name | Dr. Victor Manuel Chavez SR. |
First Address | Orange Cove, CA 93646-2243 |
Second Address | Fresno, CA 93710-8330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 19/04/2010 |