Provider Demographics
NPI:1164881801
Name:MCDOWELL, CHELSEA (BS)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 HAUSER BLVD APT 9K
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5577
Mailing Address - Country:US
Mailing Address - Phone:815-405-3201
Mailing Address - Fax:
Practice Address - Street 1:6305 YUCCA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-5057
Practice Address - Country:US
Practice Address - Phone:815-405-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer