Provider Demographics
NPI:1699875153
Name:CHITTUR EASWARAN M.D.INC
Entity type:Organization
Organization Name:CHITTUR EASWARAN M.D.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHITTUR
Authorized Official - Middle Name:V
Authorized Official - Last Name:EASWARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-527-6460
Mailing Address - Street 1:8420 PEBBLE BEACH COURT
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621
Mailing Address - Country:US
Mailing Address - Phone:714-527-6460
Mailing Address - Fax:714-527-5012
Practice Address - Street 1:3400 WEST BALL ROAD , SUITE 104
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804
Practice Address - Country:US
Practice Address - Phone:714-527-6460
Practice Address - Fax:714-527-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29301207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG29301AMedicare ID - Type Unspecified
CAA91185Medicare UPIN