MEDICARE: DR. SANT P CHAWLA 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
1	174400000X	Specialist	A45088	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95-4253354	OTHER	CA	TAX ID
2	A45088	OTHER	CA	LISCENSE #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508868837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANT P CHAWLA M.D.

Provider Business Mailing Address
First Line	:	2811 WILSHIRE BLVD
Second Line	:	SUITE 414
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4803
Country	:	US
Telephone Number	:	310-552-9999
Fax Number	:	310-201-6685

Provider Business Practice Location Address
First Line	:	2811 WILSHIRE BLVD
Second Line	:	STE 414
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4803
Country	:	US
Telephone Number	:	310-552-9999
Fax Number	:	310-201-6685

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	12/31/2014

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Directions to “ DR. SANT P CHAWLA M.D.” Practice Location

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