Marisha Chilcott MD INC
Family Medicine in Santa Rosa, CA. Organization (NPI-2).
NPI number1497940977
StatusActive
Last updated in NPPESJul 1, 2010
Details
- NPI
- 1497940977
- Entity type
- Organization (NPI-2)
- Legal business name
- Marisha Chilcott MD INC
- Organization subpart
- No
- Enumeration date
- Sep 7, 2007
- Last updated
- Jul 1, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | A88901 | CA | Yes |
Practice location
1144 Sonoma Ave Ste 104Santa Rosa, CA 95405-4812
Phone 707-542-1933 · Fax 707-542-6227
Mailing address
1144 Sonoma Ave Ste 104Santa Rosa, CA 95405-4812
Phone 707-542-1933 · Fax 707-542-6227
Authorized official
Marisha Chilcott
President
7075421933
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