Provider Demographics
NPI:1912008657
Name:CHITAYAT, RON (MD)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:CHITAYAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 WOODLAKE AVE
Mailing Address - Street 2:#260
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307
Mailing Address - Country:US
Mailing Address - Phone:818-992-8505
Mailing Address - Fax:818-992-8547
Practice Address - Street 1:7320 WOODLAKE AVE
Practice Address - Street 2:#260
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307
Practice Address - Country:US
Practice Address - Phone:818-992-8505
Practice Address - Fax:818-992-8547
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG43613207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG43613AMedicare PIN
B57375Medicare UPIN
W1491Medicare ID - Type Unspecified