Basic Information
| Provider Information | |||||||||
| NPI: | 1265677132 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAPA-RODRIGUEZ | ||||||||
| FirstName: | ALEJANDRO | ||||||||
| MiddleName: | MA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11720 | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 86304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287715487 | ||||||||
| FaxNumber: | 9287715471 | ||||||||
| Practice Location | |||||||||
| Address1: | 1003 WILLOW CREEK ROAD | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 86304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287715487 | ||||||||
| FaxNumber: | 9287715471 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2008 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 43860 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 2019-02316 | NC | Y | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 43860 | AZ | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.