Provider Demographics
NPI:1700336062
Name:CHAOS CONSULTING, INC.
Entity Type:Organization
Organization Name:CHAOS CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:OSBON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-258-6200
Mailing Address - Street 1:9600 CUYAMACA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2692
Mailing Address - Country:US
Mailing Address - Phone:619-258-6200
Mailing Address - Fax:619-258-0028
Practice Address - Street 1:1156 BOWMAN RD
Practice Address - Street 2:STE 103
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3803
Practice Address - Country:US
Practice Address - Phone:843-654-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD25298207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty