Healthcare Provider Details

I. General information

NPI: 1013118264
Provider Name (Legal Business Name): JAYSHREE CHANDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 EMBARCADERO CTR LBBY
SAN FRANCISCO CA
94111
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 415-529-4566
  • Fax: 415-291-0489
Mailing address:
  • Phone: 510-204-5514
  • Fax: 510-204-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG78537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: