Provider Demographics
NPI:1598782591
Name:LUIS A CHANES, MD INC
Entity Type:Organization
Organization Name:LUIS A CHANES, MD INC
Other - Org Name:EYE ASSOCIATES OF ORANGE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:CHANES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-364-6688
Mailing Address - Street 1:27871 MEDICAL CENTER RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6404
Mailing Address - Country:US
Mailing Address - Phone:949-364-6688
Mailing Address - Fax:949-364-6689
Practice Address - Street 1:27871 MEDICAL CENTER RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6404
Practice Address - Country:US
Practice Address - Phone:949-364-6688
Practice Address - Fax:949-364-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73198174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF30637Medicare UPIN
CAW15021AMedicare ID - Type Unspecified