Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist |
NPI | 1063966182 |
---|---|
Provider Name | Chelsea Harthorn |
First Address | Chula Vista, CA 91911-1304 |
Second Address | Chula Vista, CA 91911-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2016 |
Last Update Date | 05/08/2016 |