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Individual

CHYNEL HENNING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3816 WOODRUFF AVE, STE 104, LONG BEACH, CA 90808-2147
(562) 377-0389
Mailing address
PO BOX 7630, LAGUNA NIGUEL, CA 92607-7630

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
A26610
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A26610
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
A26610
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LAB58488F
CA
01
X558488
CHAMPUS ID
Enumeration date
09/20/2006
Last updated
06/18/2009
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