Individual
MR. CHAD VIRIYA ITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
710 LAWRENCE EXPY, DEPT 148, SANTA CLARA, CA 95051-5173
(408) 851-1850
(408) 851-1871
Mailing address
710 LAWRENCE EXPY, DEPT 148, SANTA CLARA, CA 95051-5173
(408) 851-1850
(408) 851-1871
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001611
CT
363A00000X
Physician Assistant
Primary
PA18527
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001611
PA LICENSE
CT
05
—
004236007
—
CT
01
—
37374
CONTROLLED SUBSTANCE
CT
Enumeration date
01/31/2006
Last updated
01/11/2022
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