Provider Demographics
NPI:1881746428
Name:CHI, DAVID D (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:CHI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:555 MARIN STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4150
Mailing Address - Country:US
Mailing Address - Phone:805-497-7785
Mailing Address - Fax:805-497-7728
Practice Address - Street 1:555 MARIN STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4105
Practice Address - Country:US
Practice Address - Phone:805-497-7785
Practice Address - Fax:805-497-7728
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2011-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG84570208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG72312Medicare UPIN