Provider Demographics
NPI:1619194248
Name:CHEVALIER, ANDRE M (DC)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:M
Last Name:CHEVALIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1265 EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4257
Mailing Address - Country:US
Mailing Address - Phone:408-241-8326
Mailing Address - Fax:408-241-2600
Practice Address - Street 1:1265 EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4257
Practice Address - Country:US
Practice Address - Phone:408-241-8326
Practice Address - Fax:408-241-2600
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA21269111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NR0400XChiropractic ProvidersChiropractorRehabilitation