Provider Demographics
NPI:1508921347
Name:SUZANNE CHAVES, M.D., INC.
Entity Type:Organization
Organization Name:SUZANNE CHAVES, M.D., INC.
Other - Org Name:ABSOLUTE ENDOCRINOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVES
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:805-434-5316
Mailing Address - Street 1:PO BOX 5144
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93447-5144
Mailing Address - Country:US
Mailing Address - Phone:805-434-5316
Mailing Address - Fax:805-434-5317
Practice Address - Street 1:959 LAS TABLAS RD
Practice Address - Street 2:SUITE B3
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465
Practice Address - Country:US
Practice Address - Phone:805-434-5316
Practice Address - Fax:805-434-5317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2959635207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA79914OtherMEDICAL LICENSE
5122430001Medicare NSC
CAA79914OtherMEDICAL LICENSE
CAH71337Medicare UPIN
ZZZ303327Medicare PIN