Provider Demographics
NPI:1891743910
Name:DONALDSON, CHADWICK JAMES (MD, MS, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHADWICK
Middle Name:JAMES
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:MD, MS, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2390 FARADAY AVE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7216
Mailing Address - Country:US
Mailing Address - Phone:858-909-0770
Mailing Address - Fax:858-909-0880
Practice Address - Street 1:H200 MERCY LANE
Practice Address - Street 2:
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-6646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19132208D00000X
IL036.144906207Y00000X
LAMD.200605208D00000X
CAA84567207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice