Healthcare Provider Details

I. General information

NPI: 1558983742
Provider Name (Legal Business Name): RAM CHANDRA KHATRI CHHETRI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S AKERS ST STE D
VISALIA CA
93291-5185
US

IV. Provider business mailing address

3607 N MENDONCA ST
VISALIA CA
93291-6542
US

V. Phone/Fax

Practice location:
  • Phone: 559-732-1648
  • Fax:
Mailing address:
  • Phone: 269-769-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA201422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: