Doctor Name: | MAYDER CHACON |
NPI Number: | 1194921965 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 583986 |
Business Practice Address: | 8902 Woodman Ave Arleta, CA - 913316401 |
Business Phone Number: | 8188307033 |
Business Fax Number: | |
Mailing Address: | 8902 Woodman Ave, ARLETA |
State: | CA |
Postal Code: | 913316401 |
Phone Number: | 8188307033 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0400X |
License Number: | 583986 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Case Management |
Taxonomy Definition: |