Healthcare Provider Details

I. General information

NPI: 1912008657
Provider Name (Legal Business Name): RON CHITAYAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE #260
WEST HILLS CA
91307
US

IV. Provider business mailing address

7320 WOODLAKE AVE #260
WEST HILLS CA
91307
US

V. Phone/Fax

Practice location:
  • Phone: 818-992-8505
  • Fax: 818-992-8547
Mailing address:
  • Phone: 818-992-8505
  • Fax: 818-992-8547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG43613
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: