Provider Demographics
NPI:1891593539
Name:ANOTTA, CHALLA
Entity type:Individual
Prefix:
First Name:CHALLA
Middle Name:
Last Name:ANOTTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4955 NEWPORT ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-4613
Mailing Address - Country:US
Mailing Address - Phone:720-629-3351
Mailing Address - Fax:
Practice Address - Street 1:4955 NEWPORT ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-4613
Practice Address - Country:US
Practice Address - Phone:720-629-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)