Provider Demographics
NPI:1437123601
Name:CHANDRASEKARAN, P R (MBBS MD FACS FAAOS)
Entity Type:Individual
Prefix:
First Name:P
Middle Name:R
Last Name:CHANDRASEKARAN
Suffix:
Gender:M
Credentials:MBBS MD FACS FAAOS
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Mailing Address - Street 1:PO BOX 2306
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-2306
Mailing Address - Country:US
Mailing Address - Phone:661-663-6550
Mailing Address - Fax:661-663-6259
Practice Address - Street 1:400 OLD RIVER RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9781
Practice Address - Country:US
Practice Address - Phone:661-663-6550
Practice Address - Fax:661-663-6259
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA37771207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88429Medicare UPIN