Healthcare Provider Details

I. General information

NPI: 1891966206
Provider Name (Legal Business Name): CHANDRA ORTHOPEDIC & MEDICAL CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 OLD RIVER RD
BAKERSFIELD CA
93311-9781
US

IV. Provider business mailing address

PO BOX 2306
BAKERSFIELD CA
93303-2306
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-6550
  • Fax: 661-663-6259
Mailing address:
  • Phone: 661-663-6550
  • Fax: 661-663-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PR CHANDRASEKARAN
Title or Position: PRESIDENT
Credential: MD
Phone: 661-663-6550