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Individual

MR. CHANCELOR DANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1704 W MANCHESTER AVE, SUITE 101, LOS ANGELES, CA 90047-3034
(323) 778-6215
(323) 778-6312
Mailing address
617 W MANCHESTER AVE, SUITE 101, LOS ANGELES, CA 90044-5718
(323) 750-9715

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A45227
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A452270
CA
Enumeration date
07/04/2006
Last updated
01/25/2016
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