Doctor Name: | BRADFORD J. CHEW |
NPI Number: | 1720191489 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G61736 |
Business Practice Address: | 200 Mission Boulevard Jackson, CA - 956422564 |
Business Phone Number: | 2092237500 |
Business Fax Number: | |
Mailing Address: | P.o. Box 11949, WESTMINSTER |
State: | CA |
Postal Code: | 926851949 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/16/2006 |
NPI Last Update Date: | 04/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G61736 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |