Provider Demographics
NPI:1538133822
Name:CHAVEZ, ORLANDO (DPM)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 VILLA LN STE 5
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6417
Mailing Address - Country:US
Mailing Address - Phone:707-226-2031
Mailing Address - Fax:072-521-0877
Practice Address - Street 1:3443 VILLA LN STE 5
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6417
Practice Address - Country:US
Practice Address - Phone:707-226-2031
Practice Address - Fax:072-521-0877
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2769213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11459Medicare UPIN