Provider Demographics
NPI:1922450840
Name:CHASAN, CYNTHIA BAJADA (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:BAJADA
Last Name:CHASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:LEE
Other - Last Name:BAJADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7401 VISTA DEL MAR AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4954
Mailing Address - Country:US
Mailing Address - Phone:858-395-5760
Mailing Address - Fax:
Practice Address - Street 1:7401 VISTA DEL MAR AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4954
Practice Address - Country:US
Practice Address - Phone:858-395-5760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0709512085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology