Provider Demographics
NPI:1932959459
Name:CHITAYAT, LEILA (MPA)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:CHITAYAT
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 FALL RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3722
Mailing Address - Country:US
Mailing Address - Phone:619-995-4544
Mailing Address - Fax:
Practice Address - Street 1:23501 PARK SORRENTO STE 216
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1383
Practice Address - Country:US
Practice Address - Phone:818-222-7495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA64277390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program