Provider Demographics
NPI:1033747290
Name:CHAVEZ, BRYCE TAYLOR (MD)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:TAYLOR
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 SAN DIMAS ST STE B100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2285
Mailing Address - Country:US
Mailing Address - Phone:661-326-0088
Mailing Address - Fax:
Practice Address - Street 1:3838 SAN DIMAS ST STE B100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2285
Practice Address - Country:US
Practice Address - Phone:661-326-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA199117207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine