Provider Demographics
NPI:1205022175
Name:PRICE, LA CHUNE F (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:LA CHUNE
Middle Name:F
Last Name:PRICE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK E STE 1206
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2015
Mailing Address - Country:US
Mailing Address - Phone:213-389-4544
Mailing Address - Fax:213-389-4554
Practice Address - Street 1:2030 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5011
Practice Address - Country:US
Practice Address - Phone:213-389-4544
Practice Address - Fax:213-389-4554
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19206363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical