Provider Demographics
NPI:1982657763
Name:CHAWLA, RAJESH (MD)
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:CHAWLA
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 1:900 S 1ST AVE
Mailing Address - Street 2:STE C
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7527
Mailing Address - Country:US
Mailing Address - Phone:626-566-2750
Mailing Address - Fax:626-566-2756
Practice Address - Street 1:900 S 1ST AVE
Practice Address - Street 2:STE C
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7527
Practice Address - Country:US
Practice Address - Phone:626-566-2750
Practice Address - Fax:626-566-2756
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51991207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A519910Medicaid
CA00A519910Medicaid
CAWA51991NMedicare PIN