Healthcare Provider Details

I. General information

NPI: 1265554695
Provider Name (Legal Business Name): NEIL ANJAN CHATTERJEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15720 VENTURA BLVD STE 602A
ENCINO CA
91436-2914
US

IV. Provider business mailing address

15720 VENTURA BLVD STE 602A
ENCINO CA
91436-2914
US

V. Phone/Fax

Practice location:
  • Phone: 818-386-8816
  • Fax:
Mailing address:
  • Phone: 818-386-8816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberA66747
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License NumberA66747
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA66747
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberA66747
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA66747
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA66747
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberA66747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: