Basic Information
| Provider Information | |||||||||
| NPI: | 1700336062 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHAOS CONSULTING, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9600 CUYAMACA ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SANTEE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920712692 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192586200 | ||||||||
| FaxNumber: | 6192580028 | ||||||||
| Practice Location | |||||||||
| Address1: | 1156 BOWMAN RD | ||||||||
| Address2: | STE 103 | ||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294643803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436547337 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2016 | ||||||||
| LastUpdateDate: | 01/09/2017 | ||||||||
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| AuthorizedOfficialLastName: | OSBON | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | BARTON | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6192586200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0005X | MD25298 | SC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Undersea and Hyperbaric Medicine |
No ID Information.