Provider Demographics
NPI:1407967730
Name:VARMA, CHANDRASEKHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRASEKHAR
Middle Name:
Last Name:VARMA
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 1:625 W. CITRACADO PKWY, STE 108
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025
Mailing Address - Country:US
Mailing Address - Phone:760-743-1431
Mailing Address - Fax:760-743-6455
Practice Address - Street 1:625 W. CITRACADO PKWY, STE 108
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:760-743-1431
Practice Address - Fax:760-743-6455
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32416207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA32140Medicaid
CAA32416Medicare ID - Type Unspecified
CAA32140Medicaid