Provider Demographics
NPI:1821040163
Name:CHIRITESCU, ANCA (MD)
Entity type:Individual
Prefix:DR
First Name:ANCA
Middle Name:
Last Name:CHIRITESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-0366
Mailing Address - Country:US
Mailing Address - Phone:909-227-5488
Mailing Address - Fax:
Practice Address - Street 1:WEST VALLEY DETENTION CENTER, MEDICAL OFFICE
Practice Address - Street 2:9500 ETIWANDA AVENUE
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739
Practice Address - Country:US
Practice Address - Phone:909-708-8371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA620652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OOA620650Medicare ID - Type Unspecified
H06834Medicare UPIN