Healthcare Provider Details

I. General information

NPI: 1740250570
Provider Name (Legal Business Name): CHANDER P. MALHOTRA, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE 3RD FLOOR
COLTON CA
92324-1801
US

IV. Provider business mailing address

7344 MAGNOLIA AVE SUITE 240
RIVERSIDE CA
92504-3819
US

V. Phone/Fax

Practice location:
  • Phone: 909-580-6270
  • Fax:
Mailing address:
  • Phone: 951-351-8729
  • Fax: 951-351-8463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANDER P. MALHOTRA
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 951-351-8729