Healthcare Provider Details

I. General information

NPI: 1114993813
Provider Name (Legal Business Name): RAM LALCHANDANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 COYLE AVE SUITE 301
CARMICHAEL CA
95608-0302
US

IV. Provider business mailing address

6555 COYLE AVE STE 301
CARMICHAEL CA
95608-0303
US

V. Phone/Fax

Practice location:
  • Phone: 916-961-0258
  • Fax: 916-962-1973
Mailing address:
  • Phone: 916-961-0258
  • Fax: 916-962-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG045543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: