Chavannes, Mallory
Chavannes, Mallory is an sole proprietor health care provider with primary practice located at 4650 W Sunset Blvd # 78 , Los Angeles CA 90027-6062. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Chavannes, Mallory can be contacted via phone (438) 395-1651.Contact Information
Primary practice address
4650 W Sunset Blvd # 78
Los Angeles CA 90027-6062
Phone: (438) 395-1651
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | A153763 | California |
Profile Details
| NPI number | 1356840441 |
|---|---|
| LBN Legal business name | Chavannes, Mallory |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2018 |
| Last updated | Feb 5th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356840441 | NPPES |
| California | MEDICAID | A153763 |
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