Individual
GREGORY M. CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-3910
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-3910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14776
CA
Other
Enumeration date
04/19/2007
Last updated
12/09/2008
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