Basic Information
| Provider Information | |||||||||
| NPI: | 1891966206 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHANDRA ORTHOPEDIC & MEDICAL CLINIC INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2306 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933032306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616636550 | ||||||||
| FaxNumber: | 6616636259 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 OLD RIVER RD | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933119781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616636550 | ||||||||
| FaxNumber: | 6616636259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2008 | ||||||||
| LastUpdateDate: | 04/21/2015 | ||||||||
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| AuthorizedOfficialLastName: | CHANDRASEKARAN | ||||||||
| AuthorizedOfficialFirstName: | PR | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6616636550 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.