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Individual

JULIE A CHACKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
504 W PUEBLO ST, SUITE102, SANTA BARBARA, CA 93105-6211
(805) 687-7719
(805) 682-2971
Mailing address
5575 HOLLISTER AVE, SUITE F, GOLETA, CA 93117-3825
(805) 964-3838
(805) 964-6946

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A69285
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225020571
CA
Enumeration date
08/22/2005
Last updated
11/23/2009
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