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Individual

CHARISSA LEE CHABAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
2301 CAMINO RAMON STE 160, SAN RAMON, CA 94583-2031
(925) 355-1900
(925) 355-1903
Mailing address
2301 CAMINO RAMON STE 160, SAN RAMON, CA 94583-2031
(925) 355-1900
(925) 355-1903

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2446
HI
225100000X
Physical Therapist
Primary
33494
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
560666
HI
Enumeration date
09/11/2006
Last updated
11/06/2019
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