Provider Demographics
NPI:1639590672
Name:BROWN, CHAUTALEE LASHAYIA
Entity Type:Individual
Prefix:
First Name:CHAUTALEE
Middle Name:LASHAYIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1804
Mailing Address - Country:US
Mailing Address - Phone:213-524-3844
Mailing Address - Fax:310-846-2139
Practice Address - Street 1:1000 N ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1804
Practice Address - Country:US
Practice Address - Phone:213-524-3844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker