MEDICARE: DR. DAVID D. CHI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	G84570	CA
2	2086X0206X	Surgical Oncology Physician	G84570	CA

General Provider Information

NPI Number	:	1881746428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID D. CHI M.D.

Provider Business Mailing Address
First Line	:	555 MARIN STREET
Second Line	:	SUITE 210
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4150
Country	:	US
Telephone Number	:	805-497-7785
Fax Number	:	805-497-7728

Provider Business Practice Location Address
First Line	:	555 MARIN STREET
Second Line	:	SUITE 210
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4105
Country	:	US
Telephone Number	:	805-497-7785
Fax Number	:	805-497-7728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	07/08/2011

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