Provider Demographics
NPI:1659799021
Name:MUNOZ CHAVIRA, ANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MUNOZ CHAVIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ELVIRA
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15141 WHITTIER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2173
Mailing Address - Country:US
Mailing Address - Phone:562-378-6800
Mailing Address - Fax:866-680-0657
Practice Address - Street 1:15141 WHITTIER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2173
Practice Address - Country:US
Practice Address - Phone:562-378-6800
Practice Address - Fax:866-680-0657
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143109208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA800665516Medicaid