MEDICARE: CHANDRASOMA MEDICAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1205785730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANDRASOMA MEDICAL, INC

Provider Business Mailing Address
First Line	:	950 S ARROYO PKWY STE 340
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3930
Country	:	US
Telephone Number	:	626-268-5691
Fax Number	:	626-268-5698

Provider Business Practice Location Address
First Line	:	950 S ARROYO PKWY STE 340
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3930
Country	:	US
Telephone Number	:	626-268-5691
Fax Number	:	626-268-5698

Authorized Official
Title or Position	:	OWNER
Name	:	BROOKE BAFUS CHANDRASOMA
Credential	:
Telephone Number	:	626-268-5691

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	04/20/2026

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Directions to “CHANDRASOMA MEDICAL, INC ” Practice Location

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