Healthcare Provider Details

I. General information

NPI: 1952342404
Provider Name (Legal Business Name): JAMES WILLIAM CHASE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11625 PALM DR SUITE G
DESERT HOT SPRINGS CA
92240-3629
US

IV. Provider business mailing address

11625 PALM DR SUITE G
DESERT HOT SPRINGS CA
92240-3629
US

V. Phone/Fax

Practice location:
  • Phone: 760-251-3032
  • Fax: 760-251-4703
Mailing address:
  • Phone: 760-251-3032
  • Fax: 760-251-4703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC0201410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: