| Marisha Chilcott Md Inc | |
|
1144 Sonoma Ave Ste 104 Santa Rosa CA 95405-4812 | |
| (707) 542-1933 | |
| (707) 542-6227 |
| Full Name | Marisha Chilcott Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1144 Sonoma Ave Ste 104, Santa Rosa, California |
| Authorized Official Name and Position | Marisha Chilcott (PRESIDENT) |
| Authorized Official Contact | 7075421933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marisha Chilcott Md Inc 1144 Sonoma Ave Ste 104 Santa Rosa CA 95405-4812 Ph: (707) 542-1933 | Marisha Chilcott Md Inc 1144 Sonoma Ave Ste 104 Santa Rosa CA 95405-4812 Ph: (707) 542-1933 |
| NPI Number | 1497940977 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 07/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497940977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A88901 (California) | Primary |
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