Individual
CHACE DONOVYNE IKAIKA MOLETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9500 GILMAN DR, LA JOLLA, CA 92093-5004
(619) 543-8254
Mailing address
5865 FRIARS RD APT 3217, SAN DIEGO, CA 92110-6020
(808) 782-6489
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A166812
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2018
Last updated
06/21/2022
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