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Individual

AENEAS CHANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
9 DEPOT ST UNIT 5, COLFAX, CA 95713-1390
(530) 346-1004
Mailing address
PO BOX 1390, COLFAX, CA 95713-1390
(530) 346-1004
(530) 346-1006

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
48380
CA
1835P1200X
Pharmacotherapy Pharmacist
48380
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHY57143
STATE BOARD OF PHARMACY
CA
Enumeration date
07/02/2007
Last updated
08/23/2019
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