1912246281 NPI number — CRISTINA CHANDLER MD

Table of content: CRISTINA CHANDLER MD (NPI 1912246281)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912246281 NPI number — CRISTINA CHANDLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANDLER
Provider First Name:
CRISTINA
Provider Middle Name:
Provider Name Prefix Text:
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:
MAXIM / OPRANESCU
Provider Other First Name:
CRISTINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912246281
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4150 V STREET, PSSB SUITE 1200
Provider Second Line Business Mailing Address:
UCDMC DEPT. OF ANESTHESIOLOGY & PAIN MEDICINE
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95817-1460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-734-5028
Provider Business Mailing Address Fax Number:
916-734-2975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4150 V ST.UCDMC DEPT. OF ANESTHESIOLOGY & PAIN MEDICINE
Provider Second Line Business Practice Location Address:
PSSB SUITE 1200
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95817-1460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-5028
Provider Business Practice Location Address Fax Number:
916-734-2975
Provider Enumeration Date:
02/06/2013

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: 207L00000X , with the licence number:  F 5778 , 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)

  • Identifier: F 5778 . This is a "MD LICENSE - 2113" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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