Provider Demographics
NPI:1942427588
Name:ANDRE MATHIEU CHEVALIER
Entity Type:Organization
Organization Name:ANDRE MATHIEU CHEVALIER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:MATHIEU
Authorized Official - Last Name:CHEVALIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-241-8326
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty