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Provider Information for 1932146719

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

CHAWN ELIZABETH WATKINS M.D.

Other Name:   CHAWN LEWIS
Gender: FEMALE

Individual NPI: 1932146719

Calendar   Last Updated:  2016-05-23
  Certification Date: 

Details

Name Value
NPI 1932146719
Enumeration Date 2006-06-01
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1172 N MACLAY AVE
SAN FERNANDO, CA 91340-1328
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 7138 VAN NUYS BLVD
VAN NUYS, CA 91405-3005
United States

Phone: 818-778-6240 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other DEA BL7272658
Other STATE LICENSE NUMBER CA C53380
MEDICAID IL 036-101530
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics CA C53380