Rafael Ubaldo Chavez, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12656 Issued in CA

Practice address

17487 Hurley St
City of Industry, CA 91744-5106

Phone

(626) 965-0959

Fax

(626) 912-1696

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346352085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 AGATE WAY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922775",
            "telephone_number": "626-912-1460",
            "fax_number": "626-912-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17487 HURLEY ST",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917445106",
            "telephone_number": "626-965-0959",
            "fax_number": "626-912-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "RAFAEL",
        "middle_name": "UBALDO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yu Ting Chang
• Yuan-Fei Faye Chang, M.D.
• Shyan Pay Chao
• Brenda Chavelas
• Patrick Noel Chavez
• Chen Chiropractic Clinic Inc
• Ellaine Saavedra Chen, D.D.S.
• Eric Yenjen Chen, DPM
• Jasmine Chen
• Kwan-Wen Chen

• Medical Physician Assistant in City of Industry, CA
• Providers in City of Industry, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.