Provider Demographics
NPI:1801900444
Name:CHAHAL, CHANDANDEEP SINGH (MD)
Entity type:Individual
Prefix:
First Name:CHANDANDEEP
Middle Name:SINGH
Last Name:CHAHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40335 WINCHESTER RD
Mailing Address - Street 2:SUITE E, PMB 154
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5500
Mailing Address - Country:US
Mailing Address - Phone:951-290-2766
Mailing Address - Fax:
Practice Address - Street 1:28078 BAXTER RD
Practice Address - Street 2:SUITE 230
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1402
Practice Address - Country:US
Practice Address - Phone:951-290-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA906432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI42075Medicare UPIN
CA00A906430Medicare PIN