Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A107680 | CA |
NPI | 1063622744 |
---|---|
Provider Name | Ali Cheaito |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Mission Hills, CA 91345-1116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 29/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0A1076800 | (05) | CA |