Doctor Name: | ROBERT CHILCOTE |
NPI Number: | 1194925008 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G54915 |
Business Practice Address: | 1166 K St Brawley, CA - 922272737 |
Business Phone Number: | 7603449951 |
Business Fax Number: | |
Mailing Address: | 1166 K St, BRAWLEY |
State: | CA |
Postal Code: | 922272737 |
Phone Number: | 7603449951 |
Fax Number: | |
NPI Enumeration Date: | 07/19/2007 |
NPI Last Update Date: | 07/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | G54915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |