Individual
CHANCE LAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1822 13TH AVE, OAKLAND, CA 94606-3916
(925) 408-8597
Mailing address
1822 13TH AVE, OAKLAND, CA 94606-3916
(925) 408-8597
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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