Healthcare Provider Details

I. General information

NPI: 1508245325
Provider Name (Legal Business Name): ROHIT CHETTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SAN FERNANDO RD
SAN FERNANDO CA
91340-3115
US

IV. Provider business mailing address

1172 N MACLAY AVE
SAN FERNANDO CA
91340-1328
US

V. Phone/Fax

Practice location:
  • Phone: 818-365-8086
  • Fax:
Mailing address:
  • Phone: 818-898-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA166909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: