Provider Demographics
NPI:1023061959
Name:CHAHAL, RESHAM S (MD)
Entity type:Individual
Prefix:
First Name:RESHAM
Middle Name:S
Last Name:CHAHAL
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 1:2338 ALMOND AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2026
Mailing Address - Country:US
Mailing Address - Phone:925-685-1130
Mailing Address - Fax:925-685-1162
Practice Address - Street 1:2338 ALMOND AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2026
Practice Address - Country:US
Practice Address - Phone:925-685-1130
Practice Address - Fax:925-685-1162
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG717320207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27899ZMedicare ID - Type Unspecified
CAF06674Medicare UPIN