1740506138 NPI number — DR. SANGEETA CHANDRAMAHANTI MD.

Table of content: DR. SANGEETA CHANDRAMAHANTI MD. (NPI 1740506138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740506138 NPI number — DR. SANGEETA CHANDRAMAHANTI MD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANDRAMAHANTI
Provider First Name:
SANGEETA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD.
Provider Gender Code:
F

Provider's Other Name Information

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 Information

NPI Number:
1740506138
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 MOUNT VERNON AVE RM 1241
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93306-4018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-326-2000
Provider Business Mailing Address Fax Number:
661-326-2138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 MT. VERNON AVENUE
Provider Second Line Business Practice Location Address:
KERN MEDICAL CENTRE
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-2000
Provider Business Practice Location Address Fax Number:
203-576-5022
Provider Enumeration Date:
04/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  A125146 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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