Healthcare Provider Details

I. General information

NPI: 1144936576
Provider Name (Legal Business Name): CHETAN LAMBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 HEIGHT ST
BAKERSFIELD CA
93305-2840
US

IV. Provider business mailing address

9304 MCCLINTOCK RD
BAKERSFIELD CA
93313-5065
US

V. Phone/Fax

Practice location:
  • Phone: 661-748-1300
  • Fax:
Mailing address:
  • Phone: 661-862-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95024010
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95124964
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: