Basic Information
| Provider Information | |||||||||
| NPI: | 1952075459 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAHINE | ||||||||
| FirstName: | ANTONIO | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37 ANGELL CT APT 206 | ||||||||
| Address2: | |||||||||
| City: | STANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943057124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862237673 | ||||||||
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| Practice Location | |||||||||
| Address1: | 725 WELCH RD | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504978000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2021 | ||||||||
| LastUpdateDate: | 08/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.