Doctor Name: | MICHAEL E. CHESEBRO |
NPI Number: | 1689764938 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S./CCC-SLP |
License Number: | SP11316 |
Business Practice Address: | 2811 Wilshire Blvd Suite 785 Santa Monica, CA - 904034803 |
Business Phone Number: | 3102648300 |
Business Fax Number: | 3102648360 |
Mailing Address: | 2811 Wilshire Blvd, Suite 785 SANTA MONICA |
State: | CA |
Postal Code: | 904034803 |
Phone Number: | 3102648300 |
Fax Number: | 3102648360 |
NPI Enumeration Date: | 10/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP11316 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |