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General NPI Number Information
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NPI Number | 1538347216
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Entity Type | Organization
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Legal Business Name | ESTEBAN AMBRAD-CHALELA,MD,PLLC
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 761 WILLIAMS BLVD.
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City | RICHLAND
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State | WA
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Zip | 99354
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Country | US
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Telephone | 509-946-9707
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Fax | 509-946-8145
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Provider Business Mailing Address
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Address Line | 761 WILLIAMS BLVD
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City | RICHLAND
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State | WA
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Zip | 99354
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Country | US
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Telephone | 509-946-9707
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Fax | 509-946-8145
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Authorized Official
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Title or Position | VASCULAR SURGEON
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Name | ESTEBAN AMBRAD-CHALELA
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Credential | MD
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Telephone | 509-946-9707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD00039198
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License Number State | WA
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