Basic Information
| Provider Information | |||||||||
| NPI: | 1881856458 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHITTA THIAGARAJAH MD A PROFESSIONAL MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2858 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935392858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617296854 | ||||||||
| FaxNumber: | 6617296864 | ||||||||
| Practice Location | |||||||||
| Address1: | 44725 N 10TH ST W STE110 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935343033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6619499966 | ||||||||
| FaxNumber: | 6619499926 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2008 | ||||||||
| LastUpdateDate: | 02/16/2011 | ||||||||
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| AuthorizedOfficialLastName: | CARA | ||||||||
| AuthorizedOfficialFirstName: | KELLY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLER | ||||||||
| AuthorizedOfficialTelephone: | 6617296854 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.