Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | A139223 | CA |
NPI | 1184989980 |
---|---|
Provider Name | Satyakant Chitturi |
First Address | Mountain House, CA 95391-2009 |
Second Address | Stockton, CA 95203-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2012 |
Last Update Date | 05/08/2016 |