Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G10829 | CA |
NPI | 1013005362 |
---|---|
Provider Name | Dr. David L Chittenden |
First Address | Mill Valley, CA 94941-1424 |
Second Address | San Francisco, CA 94109-5490 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
925756 | QME (01) | CA |
AC7010301 | DEA (01) | CA |