Healthcare Provider Details

I. General information

NPI: 1386782860
Provider Name (Legal Business Name): CHELVADURAI HEMA HARICHANDRAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 QUAIL CT STE 204
WALNUT CREEK CA
94596-5569
US

IV. Provider business mailing address

39 QUAIL CT STE 204
WALNUT CREEK CA
94596-5569
US

V. Phone/Fax

Practice location:
  • Phone: 925-947-5663
  • Fax: 925-472-0254
Mailing address:
  • Phone: 925-947-5663
  • Fax: 925-472-0254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC40227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: