Childs, Tracey R
Childs, Tracey R is an individual health care provider with primary practice located at 2001 Santa Monica Blvd Ste 680W , Santa Monica CA 90404-2111. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Childs, Tracey R can be contacted via phone (310) 829-8928.Contact Information
Primary practice address
2001 Santa Monica Blvd Ste 680W
Santa Monica CA 90404-2111
Phone: (310) 829-8928
Fax: (310) 315-6157
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | G73993 | California |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | G73993 | California |
Profile Details
| NPI number | 1114999489 |
|---|---|
| LBN Legal business name | Childs, Tracey R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Apr 21st, 2023 - about 3 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 | 1114999489 | NPPES |
| California | MEDICAID | 1114999489 | |
| California | Other | 00G739930 |
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