Healthcare Provider Details

I. General information

NPI: 1407262843
Provider Name (Legal Business Name): NATASHA P CHANDANANI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15825 LAGUNA CANYON RD STE 200
IRVINE CA
92618-2127
US

IV. Provider business mailing address

PO BOX 5486
ORANGE CA
92863-5486
US

V. Phone/Fax

Practice location:
  • Phone: 949-341-3499
  • Fax:
Mailing address:
  • Phone: 818-550-0900
  • Fax: 505-293-1524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA98902
License Number StateCA

VIII. Authorized Official

Name: DR. NATASHA P CHANDANANI
Title or Position: PRESIDENT
Credential: MD
Phone: 818-550-0900