Individual
KELLI A. CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 WOODLAND RD, SAINT HELENA, CA 94574-9554
(707) 963-6288
(310) 698-7054
Mailing address
2374 E PACIFICA PL, RANCHO DOMINGUEZ, CA 90220-6214
(310) 225-3244
(310) 698-7040
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
A69298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A692980
—
CA
01
—
12237
PHYSICIAN LICENSE
NV
01
—
268179
PHYSICIAN LICENSE
NY
01
—
36223
PHYSICIAN LICENSE
AZ
01
—
742025-1205
PHYSICIAN LICENSE
UT
01
—
7420275-1205
PHYSICIAN LICENSE
UT
01
—
A69298
PHYSICIAN LICENSE
CA
01
—
DR-48660
PHYSICIAN LICENSE
CO
01
—
MD184780
PHYSICIAN LICENSE
OR
Enumeration date
09/15/2006
Last updated
03/11/2022
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