Individual
JOHN ROGER CHAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 W ALAMEDA AVE, SUITE 312, BURBANK, CA 91505-4800
(818) 842-9728
(818) 842-8273
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G31984
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G319840
—
CA
01
—
00G319842
BLUE SHIELD
CA
Enumeration date
07/25/2006
Last updated
04/02/2015
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