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General NPI Number Information
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NPI Number | 1588762751
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Entity Type | Individual
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Provider Name | CHANDRIKA RIZAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 16909 Q ST
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City | OMAHA
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State | NE
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Zip | 68135-1521
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Country | US
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Telephone | 402-955-7575
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Fax | 402-955-7555
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Provider Business Mailing Address
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Address Line | 8401 W DODGE RD SUITE 280
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City | OMAHA
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State | NE
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Zip | 68114-3451
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Country | US
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Telephone | 402-955-6877
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Fax | 402-955-6880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20569
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License Number State | NE
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