Provider Demographics
NPI:1851405450
Name:CHRONIS, CAREY (MD)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:CHRONIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S VICTORIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5369
Mailing Address - Country:US
Mailing Address - Phone:805-642-4704
Mailing Address - Fax:
Practice Address - Street 1:801 S VICTORIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5369
Practice Address - Country:US
Practice Address - Phone:805-642-4704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60945208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A609450OtherPROVIDER # (LICENSE #)