Individual
MAYDER CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8902 WOODMAN AVE, ARLETA, CA 91331-6401
(818) 830-7033
Mailing address
8902 WOODMAN AVE, ARLETA, CA 91331-6401
(818) 830-7033
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
583986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EAP70468F
EAPC PROGRAM
CA
Enumeration date
06/26/2007
Last updated
07/08/2007
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