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General NPI Number Information
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NPI Number | 1013681717
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Entity Type | Individual
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Provider Name | CHELSEE JEANINE BRUBAKER
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Gender | Female
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 01/28/2024
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Provider Practice Location Address
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Address Line | 2075 SAN JOAQUIN HILLS RD
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-6505
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Country | US
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Telephone | 776-936-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 2075 SAN JOAQUIN HILLS RD
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-6505
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Country | US
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Telephone | 877-693-6266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 60274
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License Number State | CA
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