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Individual

CESAR CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2436 WABASH AVE, LOS ANGELES, CA 90033-2510
(323) 780-8756
(323) 302-0846
Mailing address
2436 WABASH AVE, LOS ANGELES, CA 90033-2510
(323) 780-8756
(323) 302-0846

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02768010
DRUG MEDI-CAL
CA
Enumeration date
10/01/2015
Last updated
01/08/2018
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