Provider Demographics
NPI:1457322067
Name:MIRELES-CHAVEZ, LUCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:
Last Name:MIRELES-CHAVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUCIA
Other - Middle Name:
Other - Last Name:MIRELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7206 N MILBURN AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-8450
Mailing Address - Country:US
Mailing Address - Phone:559-840-0066
Mailing Address - Fax:559-272-0479
Practice Address - Street 1:7206 N MILBURN AVE STE 106
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-8450
Practice Address - Country:US
Practice Address - Phone:559-840-0066
Practice Address - Fax:559-272-0479
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71537208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics