Charles W. Chidsey III, M.D., a Professional Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

CHARLES W. CHIDSEY III, M.D., A PROFESSIONAL CORPORATION

Practice address

17075 Devonshire St
Suite 106
Northridge, CA 91325-5405

Phone

(818) 363-9732

Fax

(818) 363-9853

NPI assigned

Nov 20, 2007

Last updated

Jun 20, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles W. Chidsey III, M.D.NPI 1831147735

Title

President

Phone

(818) 363-9732

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles W. Chidsey III, M.D.

  • Surgery Physician
  • Northridge, CA
  • NPI 1831147735
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1255512075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 106",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255405",
            "telephone_number": "818-363-9732",
            "fax_number": "818-363-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 106",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255405",
            "telephone_number": "818-363-9732",
            "fax_number": "818-363-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES W. CHIDSEY III, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "CHIDSEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-363-9732",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G465240",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G465240",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G46524",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Chaparyan, PHARM.D.
• Marina Chaplin, M.A, AMFT
• Emily Juliann Chapman
• Wilsa M.S. Charles Malveaux, M.D.
• Charles Rodgers Professional Dental Corporation (Northridge Dental Office)
• Charlie Anderson LLC
• Charlotte Roberson DDS., Inc (Kidz Dental Care)
• Prathima Smruthi Charugundla, D.O.
• Gail J Chase, L.C.S.W.
• Yolanda Reid Chassiakos, M.D.

• Surgery Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.