Healthcare Provider Details

I. General information

NPI: 1427714591
Provider Name (Legal Business Name): CHRISTINA MARIE CHORAZY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 S MELROSE DR
VISTA CA
92081-6641
US

IV. Provider business mailing address

380 S MELROSE DR
VISTA CA
92081-6641
US

V. Phone/Fax

Practice location:
  • Phone: 866-933-8387
  • Fax: 608-796-2618
Mailing address:
  • Phone: 866-933-8387
  • Fax: 608-796-2618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number60478
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: