Doctor Name: | DR. NEIL IRA CHAFETZ |
NPI Number: | 1568599678 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G29504 |
Business Practice Address: | 1360 W 6th St West Bldg - Ste. 100 San Pedro, CA - 907323514 |
Business Phone Number: | 3108332233 |
Business Fax Number: | 3108332213 |
Mailing Address: | 1360 W 6th St, West Bldg - Ste. 100 SAN PEDRO |
State: | CA |
Postal Code: | 907323514 |
Phone Number: | 3108332233 |
Fax Number: | 3108332213 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 01/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G29504 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |