Provider Demographics
NPI:1235529504
Name:MIRNA R CHAMBI MD INC
Entity Type:Organization
Organization Name:MIRNA R CHAMBI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MIRNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-470-7250
Mailing Address - Street 1:1420 CRESTMONT DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-4201
Mailing Address - Country:US
Mailing Address - Phone:661-873-7515
Mailing Address - Fax:661-873-7505
Practice Address - Street 1:1420 CRESTMONT DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-4201
Practice Address - Country:US
Practice Address - Phone:661-873-7515
Practice Address - Fax:661-873-7505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIRNA R CHAMBI MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty