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General NPI Number Information
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NPI Number | 1275686693
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Entity Type | Individual
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Provider Name | LYNNE LORRAINE CHAMBERS PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 25965 SOUTH NORMANDIE AVE PEDIATRICS 2ND FLOOR
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City | HARBOR CITY
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State | CA
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Zip | 90710
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Country | US
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Telephone | 310-257-6183
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 LOMA DR
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3814
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Country | US
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Telephone | 310-257-6183
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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 | PA 12232
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License Number State | CA
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