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NPI Code Detail

MEDICARE: MR. INDRANEEL CHAKRABARTY M.D.

MEDICARE: MR. INDRANEEL CHAKRABARTY M.D.
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
1207R00000XInternal Medicine PhysicianA100481CA
2208M00000XHospitalist Physician232347MA
3207RG0100XGastroenterology PhysicianA100481CA
4207R00000XInternal Medicine Physician232347MA

General Provider Information

NPI Number : 1356558621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. INDRANEEL CHAKRABARTY M.D.
Provider Business Mailing Address
First Line : PO BOX 2680
Second Line :
City : TEMECULA
State : CA
Zip : 92593-2680
Country : US
Telephone Number : 951-501-4200
Fax Number : 951-900-3110
Provider Business Practice Location Address
First Line : 31625 DE PORTOLA RD STE 101
Second Line :
City : TEMECULA
State : CA
Zip : 92592-2770
Country : US
Telephone Number : 951-501-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 04/29/2022

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