Individual
NICOLE CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
465 N ROXBURY DR, BEVERLY HILLS, CA 90210-4206
(310) 777-8800
Mailing address
535 S CURSON AVE APT 2M, LOS ANGELES, CA 90036-5293
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA22482
CA
363AS0400X
Surgical Physician Assistant
Primary
PA22482
CA
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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