Provider Demographics
NPI:1144235540
Name:CHIMA, SURENDAR SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:SURENDAR
Middle Name:SINGH
Last Name:CHIMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 EXPO PKWY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4230
Mailing Address - Country:US
Mailing Address - Phone:916-437-6400
Mailing Address - Fax:916-437-6592
Practice Address - Street 1:1400 EXPO PKWY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4230
Practice Address - Country:US
Practice Address - Phone:916-437-6400
Practice Address - Fax:916-437-6592
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG52721Medicaid
CA00G527210Medicare PIN
CAG52721Medicaid