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Individual

JOSE CARLOS CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
850 W HIGHLAND AVE, SUITE A, SAN BERNARDINO, CA 92405-3855
(909) 886-7576
Mailing address
17299 CREMELLO WAY, MORENO VALLEY, CA 92555-3369

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
14641
CA
364SW0102X
Women's Health Clinical Nurse Specialist
Primary
14641
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629234893
CA
Enumeration date
08/06/2008
Last updated
03/16/2026
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