Provider Demographics
NPI:1871832543
Name:COACHELLA VALLEY NEPHROLOGY INC
Entity Type:Organization
Organization Name:COACHELLA VALLEY NEPHROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:SHASHIBUSHAN
Authorized Official - Last Name:CHANDRASHEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-347-0707
Mailing Address - Street 1:43576 WASHINGTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8565
Mailing Address - Country:US
Mailing Address - Phone:760-347-0707
Mailing Address - Fax:760-342-9457
Practice Address - Street 1:43576 WASHINGTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8565
Practice Address - Country:US
Practice Address - Phone:760-347-0707
Practice Address - Fax:760-342-9457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty