Healthcare Provider Details

I. General information

NPI: 1750878047
Provider Name (Legal Business Name): CHELSEA ELISABETH STEWART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1437
US

IV. Provider business mailing address

1306 QUINTERO ST APT 13
LOS ANGELES CA
90026-6972
US

V. Phone/Fax

Practice location:
  • Phone: 747-210-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA1881668
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: