Individual
DR. CHAD DAVID MEDIATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
4130 LA JOLLA VILLAGE DR, SUITE 306, LA JOLLA, CA 92037-9121
(858) 455-6460
Mailing address
3651 1/2 ARNOLD AVE, 1/2, SAN DIEGO, CA 92104-3441
(216) 272-0558
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
012196
OH
225100000X
Physical Therapist
Primary
37003
CA
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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