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General NPI Number Information
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NPI Number | 1871680231
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Entity Type | Organization
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Legal Business Name | PAUL E. CHASAN, M.D., INC.
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 9850 GENESEE AVENUE SUITE 880
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-450-1555
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Fax | 858-450-1527
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Provider Business Mailing Address
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Address Line | 9850 GENESEE AVENUE SUITE 880
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-450-1555
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Fax | 858-450-1527
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Authorized Official
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Title or Position | CEO
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Name | MR. PAUL ELLIOTT CHASAN
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Credential | MD FACS
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Telephone | 858-450-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G68600
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License Number State | CA
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