Individual
MR. JUAN-CARLOS MANUEL CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1501 TROUSDALE DR, 1ST FLOOR, BURLINGAME, CA 94010-4506
(650) 652-8700
Mailing address
3308 GLENDORA DR, SAN MATEO, CA 94403-3705
(801) 867-2002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA22713
CA
363AS0400X
Surgical Physician Assistant
Primary
PA22713
CA
Other
Enumeration date
01/10/2011
Last updated
01/03/2024
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