Provider Demographics
NPI:1568693265
Name:APPLEGATE, CHAD LEE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:LEE
Last Name:APPLEGATE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615W CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6679
Mailing Address - Country:US
Mailing Address - Phone:559-679-3620
Mailing Address - Fax:
Practice Address - Street 1:5533 W HILLSDALE AVE
Practice Address - Street 2:STE C
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5138
Practice Address - Country:US
Practice Address - Phone:559-622-8500
Practice Address - Fax:559-622-9410
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20442363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant