Provider Demographics
NPI:1770825796
Name:CHASE, ELIZABETH ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:CHASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 VIA DE LA PAZ STE 203
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3545
Mailing Address - Country:US
Mailing Address - Phone:310-454-2602
Mailing Address - Fax:310-454-7514
Practice Address - Street 1:910 VIA DE LA PAZ STE 203
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3545
Practice Address - Country:US
Practice Address - Phone:310-454-2602
Practice Address - Fax:310-454-7514
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAO61252207N00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207N00000XAllopathic & Osteopathic PhysiciansDermatology