Basic Information
| Provider Information | |||||||||
| NPI: | 1952673956 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAMBERS | ||||||||
| FirstName: | KENT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LNHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2250 ESPERANZA AVE | ||||||||
| Address2: | |||||||||
| City: | PALERMO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959689720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063962746 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2430 BIRD ST | ||||||||
| Address2: | |||||||||
| City: | OROVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959654908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305387277 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2012 | ||||||||
| LastUpdateDate: | 02/07/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.