Provider Demographics
NPI:1215236096
Name:CHASIN, GIL (LAC)
Entity type:Individual
Prefix:
First Name:GIL
Middle Name:
Last Name:CHASIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4052 IVEY VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7662
Mailing Address - Country:US
Mailing Address - Phone:949-338-9987
Mailing Address - Fax:949-673-7144
Practice Address - Street 1:4052 IVEY VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-7662
Practice Address - Country:US
Practice Address - Phone:949-338-9987
Practice Address - Fax:949-673-7144
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2995171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist