Healthcare Provider Details

I. General information

NPI: 1225489065
Provider Name (Legal Business Name): RACHIT CHAWLA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2059
US

IV. Provider business mailing address

1000 W CARSON ST
TORRANCE CA
90502-2059
US

V. Phone/Fax

Practice location:
  • Phone: 310-781-3636
  • Fax: 310-972-2982
Mailing address:
  • Phone: 310-781-3636
  • Fax: 310-972-2982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2016021101
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberA161483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: