Individual
CHAD GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 N INDIAN RD, SMITH RIVER, CA 95567-9509
(707) 487-0215
(707) 487-1304
Mailing address
501 N INDIAN RD, SMITH RIVER, CA 95567-9509
(707) 487-0215
(707) 487-1304
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10396
CA
Other
Enumeration date
07/12/2005
Last updated
07/16/2007
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