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General NPI Number Information
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NPI Number | 1790030286
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Entity Type | Individual
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Provider Name | DEEPAK CHANDRA MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 5 MEDICAL PLAZA DR STE 190
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City | ROSEVILLE
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State | CA
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Zip | 95661-2867
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Country | US
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Telephone | 916-679-3590
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Fax | 530-870-8537
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Provider Business Mailing Address
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Address Line | 1300 ETHAN WAY STE 600
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City | SACRAMENTO
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State | CA
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Zip | 95825-2296
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Country | US
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Telephone |
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Fax |
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A154515
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A154515
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License Number State | CA
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