Charles W. Chidsey III, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G46524 Issued in CA

Practice address

17075 Devonshire St
Suite 106
Northridge, CA 91325-5405

Phone

(818) 363-9732

Fax

(818) 363-9853

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1831147735",
    "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": {
        "last_name": "CHIDSEY",
        "first_name": "CHARLES",
        "middle_name": "W.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G46524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Chen, DO
• Sean Xiang Chen, MD
• Siming Chen, FNP-C
• Amy Chesnut
• Christian Michael Chiavetta, D.O.
• Child and Family Guidance Center
• Child and Family Guidance Center
• Child and Family Guidance Center
• Child and Family Guidance Center
• Faith Lee Chin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.