Provider Demographics
NPI:1659341766
Name:CHAVES, ANDRE MV (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:MV
Last Name:CHAVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1007
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92564-1007
Mailing Address - Country:US
Mailing Address - Phone:951-696-9061
Mailing Address - Fax:951-696-4602
Practice Address - Street 1:8555 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4014
Practice Address - Country:US
Practice Address - Phone:562-923-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34570207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA34570Medicare ID - Type Unspecified
CAA27521Medicare UPIN