Active NPI
Sergio Chavez
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1275266090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2801 S San Pedro St
Los Angeles, CA 90011-2023 - Phone
- (323) 233-3100
- NPI assigned
- Jul 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2801 S San Pedro St
Los Angeles, CA 90011-2023
Mailing address
1835 Mulberry Way
Upland, CA 91784-1527
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1275266090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1835 MULBERRY WAY",
"city": "UPLAND",
"state": "CA",
"postal_code": "917841527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900112023",
"telephone_number": "323-233-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "SERGIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-08",
"last_updated": "2022-07-08",
"certification_date": "2022-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.