Individual
EARL CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 16TH STREET, 4TH FLOOR, SAN FRANCISCO, CA 94143-0110
(415) 476-5001
Mailing address
550 16TH STREET, 4TH FLOOR, SAN FRANCISCO, CA 94143-0110
(415) 476-5001
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
PTL12708
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2022
Last updated
11/29/2023
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