Healthcare Provider Details

I. General information

NPI: 1538621149
Provider Name (Legal Business Name): MEGAN CRAIG CHITLUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN MARIE CRAIG

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 TOWN CENTER PKWY STE 105S90
SANTEE CA
92071-5800
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 619-713-7880
  • Fax:
Mailing address:
  • Phone: 619-713-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA178909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: