Basic Information
| Provider Information | |||||||||
| NPI: | 1902304512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | CHELSEA | ||||||||
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| Credential: | RT(R)(M) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 512 CATHEY RD | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296213615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8646342823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 BON AIR RD | ||||||||
| Address2: | |||||||||
| City: | GREENBRAE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949041702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159257000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2018 | ||||||||
| LastUpdateDate: | 06/16/2018 | ||||||||
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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 | 2471M2300X | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Mammography |
ID Information
| ID | Type | State | Issuer | Description | 18802 | 01 | AZ | CRT | OTHER | 00108756 | 01 | CA | CALIFORNIA STATE RHM | OTHER | 520580 | 01 | ARRT | OTHER |