Healthcare Provider Details

I. General information

NPI: 1225391410
Provider Name (Legal Business Name): ARTHI CHAWLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTHERN INDIAN HEALTH COUNCIL 4058 WILLOWS ROAD PO BOX 2128
ALPINE CA
91901
US

IV. Provider business mailing address

4058 WILLOWS RD
ALPINE CA
91901-1668
US

V. Phone/Fax

Practice location:
  • Phone: 619-445-1188
  • Fax:
Mailing address:
  • Phone: 619-445-1188
  • Fax: 619-659-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number293934
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD455344
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA150781
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: