Organization
CHAYA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAVALIT CHAYA M.D. (OFFICER)
(909) 796-2625
Entity
Organization
Contact information
Practice address
11761 WELEBIR ST, LOMA LINDA, CA 92354-3636
(909) 796-2625
Mailing address
11761 WELEBIR ST, LOMA LINDA, CA 92354-3636
(909) 796-2625
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
GR0085800
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0085800
—
CA
Enumeration date
06/12/2007
Last updated
08/22/2020
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