Provider Demographics
NPI:1851412837
Name:RON CHITAYAT MD INC
Entity Type:Organization
Organization Name:RON CHITAYAT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHITAYAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-992-8505
Mailing Address - Street 1:7320 WOODLAKE AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1470
Mailing Address - Country:US
Mailing Address - Phone:818-992-8505
Mailing Address - Fax:
Practice Address - Street 1:7320 WOODLAKE AVE STE 260
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1470
Practice Address - Country:US
Practice Address - Phone:818-992-8505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB57375Medicare UPIN
CAW1491Medicare ID - Type Unspecified