Provider Demographics
NPI:1942303219
Name:CHUA-LADDARAN, ANITA T (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:T
Last Name:CHUA-LADDARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANITA
Other - Middle Name:CHUA
Other - Last Name:LADDARAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2105 BEVERLY BLVD
Mailing Address - Street 2:STE 117
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057
Mailing Address - Country:US
Mailing Address - Phone:213-413-8742
Mailing Address - Fax:213-413-6482
Practice Address - Street 1:2105 BEVERLY BLVD
Practice Address - Street 2:STE 117
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:213-413-8742
Practice Address - Fax:213-413-6482
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA365070208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0064390OtherMEDICAL