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Provider Information for 1134264518



DR. JOHN MANUEL CHAVES DDS

Gender: MALE

Individual NPI: 1134264518

Calendar Last Updated: 2013-11-19

Details

Name Value
NPI 1134264518
Enumeration Date 2007-02-21
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 5312 COMERCIO LANE #A
WOODLAND HILLS, CA 91364
United States

Phone: 818-999-2707 | Fax: 818-703-1998
View Map External Link
Primary Practice Address 5312 COMERCIO LANE #A
WOODLAND HILLS, CA 91364
United States

Phone: 818-999-2707 | Fax: 818-703-1998
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 39383