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Individual

CHASEN WYNN CHASTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
41945 BIG BEAR BLVD, SUITE 200, BIG BEAR LAKE, CA 92315
(909) 866-5070
Mailing address
217 W COUNTY LINE ROAD APT #2, CALIMESA, CA 92320

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
689293
CA

Other

Enumeration date
08/25/2017
Last updated
03/17/2018
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