Provider Demographics
NPI:1588828180
Name:CHAWLA, HARISH C (MD)
Entity Type:Individual
Prefix:DR
First Name:HARISH
Middle Name:C
Last Name:CHAWLA
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 1:34 MODESTO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-0930
Mailing Address - Country:US
Mailing Address - Phone:714-389-1555
Mailing Address - Fax:714-389-1555
Practice Address - Street 1:34 MODESTO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-0930
Practice Address - Country:US
Practice Address - Phone:714-389-1555
Practice Address - Fax:714-389-1555
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-12
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50753208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery