Provider Demographics
NPI:1508166307
Name:CHRISTOPHER ZITO, M.D., FCCP, INC
Entity Type:Organization
Organization Name:CHRISTOPHER ZITO, M.D., FCCP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-376-4074
Mailing Address - Street 1:14860 ROSCOE BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4665
Mailing Address - Country:US
Mailing Address - Phone:818-376-4074
Mailing Address - Fax:818-376-4082
Practice Address - Street 1:14860 ROSCOE BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4665
Practice Address - Country:US
Practice Address - Phone:818-376-4074
Practice Address - Fax:818-376-4082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G411420Medicaid
CA00G411420Medicaid
CA1285786343Medicare NSC
CAG41142Medicare PIN