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1720693682
CHANTAL ELIZAGA
SAN RAFAEL, CA
NPI
1720693682
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA 60625)
Enumeration Date
2020-09-08
Last Update Date
2022-02-10
Business Address
CHANTAL ELIZAGA
50 ACACIA AVE
SAN RAFAEL, CA 94901-2230
Phone number: 415-457-4440
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Mailing Address
CHANTAL ELIZAGA
643 S ORANGE DR
LOS ANGELES, CA 90036-3507
Phone number:
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