1225049356 NPI number — RAMA E CHANDRAN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225049356 NPI number — RAMA E CHANDRAN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CHANDRAN

Provider First Name:

RAMA

Provider Middle Name:

E

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1225049356

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/24/2024

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

4477 W 118TH ST STE 402

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

HAWTHORNE

Provider Business Mailing Address State Name:

CA

Provider Business Mailing Address Postal Code:

90250-2259

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

310-644-1151

Provider Business Mailing Address Fax Number:

310-644-3115

Provider First Line Business Practice Location Address:

4201 TORRANCE BLVD STE 310

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

TORRANCE

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

90503-4533

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

310-644-1151

Provider Business Practice Location Address Fax Number:

310-644-3115

Provider Enumeration Date:

08/11/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207X00000X , with the licence number:  A32401 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 953447493 . This is a "EXCELLUS ROCHESTER NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 953447493002 . This is a "AETNA COLUMBIA SC" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 953447493 . This is a "BLUE SHIELD OF CA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 953447493 . This is a "UNITED HEALTHCARE INS SLC" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
• Identifier: 953447493 . This is a "BLUE CROSS OF CA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 953447493003 . This is a "CIGNA CHATTANOOGA TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 00A324010 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
• Identifier: 953447493 . This is a "HEALTHNET VANUYS CA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 00A324010 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 953447493 . This is a "UNITED HEALTHCARE ATLANTA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 953447493 . This is a "FOUNDATION ADMIN SVC INC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".