Individual
CARLOS O CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 OTAY LAKES RD, 110, BONITA, CA 91902-2443
(858) 633-7546
(760) 634-6785
Mailing address
384 MINOT AVE, CHULA VISTA, CA 91910-2937
(858) 633-7546
(760) 634-6785
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A98477
CA
Other
Enumeration date
07/11/2013
Last updated
08/06/2015
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