MEDICARE: DR. CHITTUR EASWARAN M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	G29301	CA

General Provider Information

NPI Number	:	1750314993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHITTUR EASWARAN M.D

Provider Business Mailing Address
First Line	:	8420 PEBBLE BEACH DR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-1054
Country	:	US
Telephone Number	:	714-527-6460
Fax Number	:	714-527-5012

Provider Business Practice Location Address
First Line	:	3400 W BALL RD STE 104
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3735
Country	:	US
Telephone Number	:	714-527-6460
Fax Number	:	714-527-5012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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