Basic Information
Provider Information
NPI: 1053357681
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANCH
FirstName: KITCHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3916 STATE ST
Address2: #300
City: SANTA BARBARA
State: CA
PostalCode: 931055602
CountryCode: US
TelephoneNumber: 8055633011
FaxNumber: 8055645087
Practice Location
Address1: 43830 10TH ST W
Address2:  
City: LANCASTER
State: CA
PostalCode: 935344826
CountryCode: US
TelephoneNumber: 6619401421
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2006
LastUpdateDate: 01/03/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XA32777CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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