Basic Information
| Provider Information | |||||||||
| NPI: | 1700803798 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAKRABARTY | ||||||||
| FirstName: | MILAN | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CHAKRABARTY | ||||||||
| OtherFirstName: | MILANKUMAR | ||||||||
| OtherMiddleName: | S | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 5400 | ||||||||
| Address2: | |||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925440400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516522252 | ||||||||
| FaxNumber: | 9516586476 | ||||||||
| Practice Location | |||||||||
| Address1: | 1003 E FLORIDA AVE | ||||||||
| Address2: | # 101 | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925434510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516522252 | ||||||||
| FaxNumber: | 9516586476 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 07/29/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | A36675 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.