Provider Demographics
NPI:1568593671
Name:PATALAPPA CHANDRASHEKAR M D INC
Entity Type:Organization
Organization Name:PATALAPPA CHANDRASHEKAR M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PATALAPPA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRASHEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-949-5273
Mailing Address - Street 1:44215 15TH ST W STE 211
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5504
Mailing Address - Country:US
Mailing Address - Phone:661-949-5273
Mailing Address - Fax:661-726-6603
Practice Address - Street 1:44215 15TH ST W STE 211
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5504
Practice Address - Country:US
Practice Address - Phone:661-949-5273
Practice Address - Fax:661-726-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48344Medicare PIN
CAW22187Medicare PIN