Charles W. Chidsey Iii, M.d., a Professional Corporation

NPI #1255512075 in Northridge, California

Provider Information

NPI Number: 1255512075
Entity Type: Organization
Organization Name: Charles W. Chidsey Iii, M.d., a Professional Corporation
Primary Specialty: Surgery
Enumeration Date: Nov 20, 2007
Last Updated: Jun 20, 2012

Practice Location

Address: 17075 DEVONSHIRE ST
Address 2: SUITE 106
City: Northridge
State: California
ZIP Code: 91325-5405
Phone: (818) 363-9732

Authorized Official

Name: CHARLES W. CHIDSEY III, M.D.
Title: PRESIDENT
Phone: (818) 363-9732

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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