Healthcare Provider Details

I. General information

NPI: 1881801470
Provider Name (Legal Business Name): KHIN CHIT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 WEST LN
STOCKTON CA
95210-3377
US

IV. Provider business mailing address

2845 ZELDA RD APR C11
MONTGOMERY AL
36106-2604
US

V. Phone/Fax

Practice location:
  • Phone: 209-476-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL2779
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA139317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: