Individual
ELIZA CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
945 S BILLINGS WAY, ANAHEIM, CA 92808-2380
(575) 528-9667
Mailing address
945 S BILLINGS WAY, ANAHEIM, CA 92808-2380
(575) 528-9667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA53738
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2016
Last updated
09/27/2016
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