Individual
DR. MARC DAVID CHALET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2811 WILSHIRE BLVD, SUITE 615, SANTA MONICA, CA 90403-4803
(310) 828-4071
(310) 828-6734
Mailing address
2811 WILSHIRE BLVD, SUITE 615, SANTA MONICA, CA 90403-4803
(310) 828-4071
(310) 828-6734
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
G38996
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G389960
BLUE SHIELD
CA
05
—
00G389960
—
CA
01
—
G38996
BLUE CROSS
CA
Enumeration date
07/02/2006
Last updated
03/13/2008
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