Organization
LIFEPHYSICIAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA V. CHANCE MD (OWNER)
(646) 251-1992
Entity
Organization
Contact information
Practice address
999 WATERSIDE DR STE 2525, NORFOLK, VA 23510-3316
(925) 824-3198
(949) 655-8602
Mailing address
5030 E LAKESHORE DR, SAN RAMON, CA 94582-4822
(646) 251-1992
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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