Basic Information
Provider Information
NPI: 1457781718
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARAMCHANDANI
FirstName: GIRISH
MiddleName: JAGDISH
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12900 PARK PLAZA DR STE 150
Address2:  
City: CERRITOS
State: CA
PostalCode: 907039329
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4821 N STONE AVE
Address2:  
City: TUCSON
State: AZ
PostalCode: 857045727
CountryCode: US
TelephoneNumber: 5203143300
FaxNumber: 5202931597
Other Information
ProviderEnumerationDate: 11/22/2013
LastUpdateDate: 09/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X036141511ILN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X036141511ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X008566AZY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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