Basic Information
| Provider Information | |||||||||
| NPI: | 1669582433 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHATWIN | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | LEIGHAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10470 OLD PLACERVILLE RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958272539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307493340 | ||||||||
| FaxNumber: | 5307493479 | ||||||||
| Practice Location | |||||||||
| Address1: | 470 PLUMAS BLVD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959915077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307493340 | ||||||||
| FaxNumber: | 5307493479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 05/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A72130 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00779823 | 01 | CA | RAILROAD MEDICARE | OTHER | 1669582433 | 05 | CA | MEDICAID | BC6520767 | 01 | CA | DEA | OTHER |