Mancilla, Lee Chaidez

Mancilla, Lee Chaidez is an individual health care provider with primary practice located at 1711 Ocean Park Blvd , Santa Monica CA 90405-4901. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mancilla, Lee Chaidez can be contacted via phone (310) 450-4773.

Contact Information

Primary practice address
1711 Ocean Park Blvd Santa Monica CA 90405-4901
Phone: (310) 450-4773
Fax: (310) 450-0873
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA19534 California
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 19534 California

Profile Details

NPI number 1356526495
LBN Legal business name Mancilla, Lee Chaidez
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2008
Last updated Aug 17th, 2010 - about 16 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.

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