MEDICARE: DAN E CHATWIN

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
1	225100000X	Physical Therapist	6128	CA

General Provider Information

NPI Number	:	1538363155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN E CHATWIN

Provider Business Mailing Address
First Line	:	24 HAMMOND STE C
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-1680
Country	:	US
Telephone Number	:	949-770-6022
Fax Number	:	949-770-7084

Provider Business Practice Location Address
First Line	:	14708 HAWTHORNE BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-1523
Country	:	US
Telephone Number	:	310-676-4151
Fax Number	:	310-676-4169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	07/08/2007

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Directions to “ DAN E CHATWIN ” Practice Location

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