=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972440972
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORCAL NEPHROLOGY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2026
-----------------------------------------------------
Last Update Date | 04/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 853 COMMODORE DR APT 550
-----------------------------------------------------
City | SAN BRUNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94066-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-471-1908
-----------------------------------------------------
Fax | 925-204-2149
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 853 COMMODORE DR APT 550
-----------------------------------------------------
City | SAN BRUNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94066-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-471-1908
-----------------------------------------------------
Fax | 925-204-2149
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. ANIRUDH CHANDRA
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 925-471-1908
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------