Healthcare Provider Details

I. General information

NPI: 1093893091
Provider Name (Legal Business Name): PREMJIT S CHAHAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 EAST ST STE 340
CONCORD CA
94520-2081
US

IV. Provider business mailing address

2222 EAST ST STE 340
CONCORD CA
94520-2081
US

V. Phone/Fax

Practice location:
  • Phone: 925-363-0069
  • Fax: 925-363-0077
Mailing address:
  • Phone: 925-363-0069
  • Fax: 925-363-0077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA78375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: