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CHASE KRIVASHEI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4650 LINCOLN BLVD, MARINA DEL REY, CA 90292-6306
(310) 823-8911
(310) 577-5694
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4896
TN
363A00000X
Physician Assistant
Primary
PA65149
CA
363AM0700X
Medical Physician Assistant
4896
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q072569
TN
Enumeration date
01/05/2022
Last updated
03/05/2025
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