Provider Demographics
NPI:1396812707
Name:WONSON, CHADY (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:CHADY
Middle Name:
Last Name:WONSON
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MONTGOMERY ST
Mailing Address - Street 2:SUITE 780
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3406
Mailing Address - Country:US
Mailing Address - Phone:415-544-9104
Mailing Address - Fax:415-544-9106
Practice Address - Street 1:250 MONTGOMERY ST
Practice Address - Street 2:SUITE 780
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3406
Practice Address - Country:US
Practice Address - Phone:415-544-9104
Practice Address - Fax:415-544-9106
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 17858111N00000X
CAAC 6406171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist