Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | C51353 | CA |
NPI | 1952321846 |
---|---|
Provider Name | Talal Chatila |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C513530 | (05) | CA |
F53838 | (02) | CA |
GR0053510 | (05) | CA |