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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
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 39383
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location