Healthcare Provider Details

I. General information

NPI: 1609139823
Provider Name (Legal Business Name): ANGELA CHANDNA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 N PALM AVE SUITE 101
FRESNO CA
93711-5504
US

IV. Provider business mailing address

PO BOX 27906
LOS ANGELES CA
90027-0906
US

V. Phone/Fax

Practice location:
  • Phone: 559-432-9800
  • Fax:
Mailing address:
  • Phone: 323-630-3250
  • Fax: 323-962-5477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: