Provider Demographics
NPI:1992737811
Name:CHADAM ASSOCIATES INC
Entity type:Organization
Organization Name:CHADAM ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:TAKII
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:661-763-4194
Mailing Address - Street 1:337 S 10TH ST
Mailing Address - Street 2:#G
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-3300
Mailing Address - Country:US
Mailing Address - Phone:661-763-4194
Mailing Address - Fax:661-763-5792
Practice Address - Street 1:337 S 10TH ST
Practice Address - Street 2:#G
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3300
Practice Address - Country:US
Practice Address - Phone:661-763-4194
Practice Address - Fax:661-763-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6033261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ90568ZMedicare ID - Type Unspecified