Provider Demographics
NPI:1891312153
Name:ANNA MUNOZ CHAVIRA, MD, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ANNA MUNOZ CHAVIRA, MD, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:FRIENDLY HILLS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ CHAVIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-378-6800
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:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1073658571Medicaid