1235278250 NPI number — NATALIA ROCIO CHAVEZ STEWART M.D.

Table of content: NATALIA ROCIO CHAVEZ STEWART M.D. (NPI 1235278250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235278250 NPI number — NATALIA ROCIO CHAVEZ STEWART M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAVEZ STEWART
Provider First Name:
NATALIA
Provider Middle Name:
ROCIO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAVEZ CHIANG
Provider Other First Name:
NATALIA
Provider Other Middle Name:
ROCIO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235278250
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21832 CACTUS AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-924-6500
Provider Business Mailing Address Fax Number:
855-306-0134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11725 SLATE AVENUE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-352-1700
Provider Business Practice Location Address Fax Number:
951-352-9117
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  2006-0325 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X , with the licence number: A131993 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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