Provider Demographics
NPI:1063092369
Name:FAUER, CHASE (DO)
Entity type:Individual
Prefix:
First Name:CHASE
Middle Name:
Last Name:FAUER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 W DEER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2140
Mailing Address - Country:US
Mailing Address - Phone:623-312-2265
Mailing Address - Fax:
Practice Address - Street 1:7831 W DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2140
Practice Address - Country:US
Practice Address - Phone:623-312-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-11
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ011200207Q00000X
CA20A21101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine