Healthcare Provider Details

I. General information

NPI: 1932959459
Provider Name (Legal Business Name): LEILA CHITAYAT MPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23501 PARK SORRENTO STE 216
CALABASAS CA
91302-1383
US

IV. Provider business mailing address

23501 PARK SORRENTO STE 216
CALABASAS CA
91302-1383
US

V. Phone/Fax

Practice location:
  • Phone: 818-222-7495
  • Fax:
Mailing address:
  • Phone: 818-222-7495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA64277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: