Active NPI
Gary A Chavez, MD
- Emergency Medicine Physician
- Orange, CA
National Provider Identifier
1720096209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- G64289
- Practice address
- 1100 W Stewart Dr
Orange, CA 92868-3849 - Phone
- (714) 633-9111
- NPI assigned
- Aug 3, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G64289 | CA | Primary |
Addresses
Primary practice location
1100 W Stewart Dr
Orange, CA 92868-3849
Mailing address
PO Box 690
Long Beach, CA 90801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G642890 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64289 | CA | MD | Pediatric Dentist |
| G64289 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1720096209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 690",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W STEWART DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683849",
"telephone_number": "714-633-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "GARY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "G64289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G642890",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.