Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | G46606 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | G46606 | CA |
NPI | 1053452300 |
---|---|
Provider Name | Dr. Nicole Amelie Chauche |
First Address | San Diego, CA 92131-1825 |
Second Address | San Diego, CA 92131-1825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 13/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C04261 | (02) | CA |