Provider Demographics
NPI:1700202207
Name:PUJA CHITKARA M.D. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PUJA CHITKARA M.D. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHITKARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-289-9145
Mailing Address - Street 1:3830 VALLEY CENTRE DR
Mailing Address - Street 2:SUITE 705-815
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3320
Mailing Address - Country:US
Mailing Address - Phone:619-289-9145
Mailing Address - Fax:
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 216
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:619-623-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97619207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty