Individual
CHANA IVY CHANTAWANSRI CHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4650 SUNSET BOULEVARD #83, 150, LOS ANGELES, CA 90027
(323) 361-2120
Mailing address
4550 COLDWATER CANYON, 204, STUDIO CITY, CA 91604
(818) 383-8065
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A112215
CA
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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