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General NPI Number Information
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NPI Number | 1750465712
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Entity Type | Individual
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Provider Name | SUDARSHAN CHATTERJEE MD FACC
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4950 SAN BERNARDINO ST STE 208
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City | MONTCLAIR
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State | CA
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Zip | 91763-2328
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Country | US
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Telephone | 978-430-3082
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Fax |
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Provider Business Mailing Address
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Address Line | 5810 E TRAPPER TRL
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City | ANAHEIM
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State | CA
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Zip | 92807-4734
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Country | US
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Telephone | 909-398-1503
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Fax | 909-398-4950
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 53581
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | C43324
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License Number State | CA
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