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Individual

CHAUNCEY L MURDOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LVN

Contact information

Practice address
1101 FLORIDA ST, IMPERIAL BEACH, CA 91932-2907
(619) 423-3295
Mailing address
1101 FLORIDA ST, IMPERIAL BEACH, CA 91932-2907
(619) 423-3295

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
209265
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RVN004450
CA
Enumeration date
10/11/2007
Last updated
10/11/2007
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