Organization Active NPI

Marco Chavez MD Corp

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1245675412
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A115932 Issued in CA
Legal business name
MARCO CHAVEZ MD CORP
Practice address
3761 Centre St
304
San Diego, CA 92103-0919
Phone
(619) 344-7036
Fax
(619) 291-4426
NPI assigned
May 1, 2013
Last updated
May 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Marco Antonio Chavez, M.D.NPI 1619274743
Title
President
Phone
(619) 344-7036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A115932 CA Primary

Addresses

Primary practice location

3761 Centre St
304
San Diego, CA 92103-0919

Mailing address

3914 3Rd Ave
San Diego, CA 92103-3003
Phone (619) 291-4808

National Provider Directory

National Provider Directory

Locations

1855 1st Ave
Ste 200B
San Diego, CA 92101
Phone (619) 233-4044

3914 3rd Ave
San Diego, CA 92103
Phone (619) 291-4808

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1245675412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033003",
            "telephone_number": "619-291-4808",
            "fax_number": "619-291-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3761 CENTRE ST",
            "address_2": "304",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921030919",
            "telephone_number": "619-344-7036",
            "fax_number": "619-291-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCO CHAVEZ MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "MARCO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-344-7036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A115932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.