Healthcare Provider Details

I. General information

NPI: 1538363155
Provider Name (Legal Business Name): DAN E CHATWIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14708 HAWTHORNE BLVD
LAWNDALE CA
90260-1523
US

IV. Provider business mailing address

24 HAMMOND STE C
IRVINE CA
92618-1680
US

V. Phone/Fax

Practice location:
  • Phone: 310-676-4151
  • Fax: 310-676-4169
Mailing address:
  • Phone: 949-770-6022
  • Fax: 949-770-7084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: