MEDICARE: ANGELA DAWN CHEVALIER NELSON MA FAAA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AU2202	CA

General Provider Information

NPI Number	:	1033385638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA DAWN CHEVALIER NELSON MA FAAA

Provider Business Mailing Address
First Line	:	4418 VINELAND AVE
Second Line	:	SUITE 123
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-3457
Country	:	US
Telephone Number	:	818-985-8180
Fax Number	:	818-763-1809

Provider Business Practice Location Address
First Line	:	4418 VINELAND AVE
Second Line	:	SUITE 123
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-3457
Country	:	US
Telephone Number	:	818-985-8180
Fax Number	:	818-763-1809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	05/02/2008

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