Healthcare Provider Details

I. General information

NPI: 1538596101
Provider Name (Legal Business Name): LAUCHLAN CHAMBERS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11160 WARNER AVENUE 311
FOUNTAIN VALLEY CA
92708-4055
US

IV. Provider business mailing address

11160 WARNER AVENUE 311
FOUNTAIN VALLEY CA
92708-4055
US

V. Phone/Fax

Practice location:
  • Phone: 714-850-7300
  • Fax: 714-957-7348
Mailing address:
  • Phone: 714-850-7300
  • Fax: 714-957-7348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA106366
License Number StateCA

VIII. Authorized Official

Name: DR. KENNETH LAUCHLAN CHAMBERS
Title or Position: PRESIDENT
Credential: MD
Phone: 714-850-7300