Healthcare Provider Details

I. General information

NPI: 1932146719
Provider Name (Legal Business Name): CHAWN ELIZABETH WATKINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHAWN ELIZABETH LEWIS M.D.

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/07/2023
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7138 VAN NUYS BLVD
VAN NUYS CA
91405-3005
US

IV. Provider business mailing address

1172 N MACLAY AVE
SAN FERNANDO CA
91340-1328
US

V. Phone/Fax

Practice location:
  • Phone: 818-778-6240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC53380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: