Individual
CHAD ISMAEL CORREA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-5164
Mailing address
4905 TYROLITE ST, RIVERSIDE, CA 92509-4079
(951) 318-7232
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A164602
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2018
Last updated
12/06/2021
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