Individual
MADISYN CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
5500 CAMPANILE DR, SAN DIEGO, CA 92182-0001
(619) 594-7651
Mailing address
5500 CAMPANILE DR, SAN DIEGO, CA 92182-0001
(619) 594-7651
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2000035929
CA
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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