Provider Demographics
NPI:1013098557
Name:CHANDRASHEKAR, JAMBUR ERIAH (MD)
Entity type:Individual
Prefix:DR
First Name:JAMBUR
Middle Name:ERIAH
Last Name:CHANDRASHEKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:81719 DR. CARREON BLVD
Mailing Address - Street 2:STE 2A
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5518
Mailing Address - Country:US
Mailing Address - Phone:760-342-8898
Mailing Address - Fax:760-342-9457
Practice Address - Street 1:81719 DR. CARREON BLVD
Practice Address - Street 2:STE A
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201
Practice Address - Country:US
Practice Address - Phone:760-347-0707
Practice Address - Fax:760-347-3378
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA33785207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A337850Medicare PIN