Individual
JOSE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16491 LAKESHORE DR, LAKE ELSINORE, CA 92530-6723
(951) 674-0309
(951) 674-0419
Mailing address
16491 LAKESHORE DR, LAKE ELSINORE, CA 92530-6723
(951) 674-0309
(951) 674-0419
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
180335
CA
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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