Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A486570 | CA |
NPI | 1003833930 |
---|---|
Provider Name | Ian Chait |
First Address | Orange, CA 92856-0628 |
Second Address | Orange, CA 92868-3849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 19/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A486570 | (05) | CA |
00A486570 | BLUE SHIELD (01) | CA |
F83755 | (02) |