Provider Demographics
NPI:1336466465
Name:ISRAEL P CHAMBI M D & MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:ISRAEL P CHAMBI M D & MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:PEDRO
Authorized Official - Last Name:CHAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-973-0810
Mailing Address - Street 1:112 S MONTGOMERY WAY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3500
Mailing Address - Country:US
Mailing Address - Phone:714-973-0810
Mailing Address - Fax:714-973-0840
Practice Address - Street 1:801 N TUSTIN AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3608
Practice Address - Country:US
Practice Address - Phone:714-973-0810
Practice Address - Fax:714-973-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34163207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A341630Medicaid
CA00A341630Medicaid