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NPI Code Detail

MEDICARE: DR. AVA LOU CARMICHAEL CHASE ARNP

MEDICARE: DR. AVA LOU CARMICHAEL CHASE ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95000602CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
195000602OTHERCA95000602

General Provider Information

NPI Number : 1164496386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AVA LOU CARMICHAEL CHASE ARNP
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number :
Provider Business Practice Location Address
First Line : 5454 EL CAJON BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-3621
Country : US
Telephone Number : 619-515-2400
Fax Number : 619-546-9900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 08/17/2023

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