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General NPI Number Information
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NPI Number | 1730591041
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Entity Type | Organization
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Legal Business Name | RANGRAM CHANDRAN MD INC
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 11/28/2014
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Provider Practice Location Address
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Address Line | 304 BANNER CT SUITE 1
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City | MODESTO
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State | CA
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Zip | 95356-9194
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Country | US
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Telephone | 209-572-2020
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Fax | 209-572-2040
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Provider Business Mailing Address
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Address Line | PO BOX 576067
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City | MODESTO
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State | CA
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Zip | 95357-6067
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Country | US
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Telephone | 415-535-7900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANGRAM CHANDRAN
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Credential | MD
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Telephone | 415-535-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A81157
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License Number State | CA
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