Individual
DR. CHANTEL MARISA DE LA ROCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1417 W BEVERLY BLVD, SUITE 102, MONTEBELLO, CA 90640-4123
(323) 728-3270
(323) 728-2141
Mailing address
1417 W BEVERLY BLVD, SUITE 102, MONTEBELLO, CA 90640-4123
(323) 728-3270
(323) 728-2141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A81708
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A817080
—
CA
Enumeration date
08/30/2006
Last updated
08/13/2013
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