Healthcare Provider Details

I. General information

NPI: 1528256468
Provider Name (Legal Business Name): LAURA ANN GARCIA-CHANDLER RN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 MEYER PL
COSTA MESA CA
92627-2967
US

IV. Provider business mailing address

2045 MEYER PL
COSTA MESA CA
92627-2967
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-6725
  • Fax: 949-515-6726
Mailing address:
  • Phone: 949-515-6725
  • Fax: 949-515-6726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number430132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: