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Individual

KELLI A. CHASE

Active
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Individual

KELLI A. CHASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
A69298
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A692980
—
CA
01
—
12237
PHYSICIAN LICENSE
NV
01
—
268179
PHYSICIAN LICENSE
NY
01
—
36223
PHYSICIAN LICENSE
AZ
01
—
742025-1205
PHYSICIAN LICENSE
UT
01
—
7420275-1205
PHYSICIAN LICENSE
UT
01
—
A69298
PHYSICIAN LICENSE
CA
01
—
DR-48660
PHYSICIAN LICENSE
CO
01
—
MD184780
PHYSICIAN LICENSE
OR
Enumeration date
09/15/2006
Last updated
03/11/2022
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