Individual
RAFAEL UBALDO CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
17487 HURLEY ST, CITY OF INDUSTRY, CA 91744-5106
(626) 965-0959
(626) 912-1696
Mailing address
3651 AGATE WAY, WEST COVINA, CA 91792-2775
(626) 912-1460
(626) 912-1696
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12656
CA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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