MEDICARE: VANITA G CHAWLA M,D., M.P.H

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	2084P0800X	Psychiatry Physician	A79515	CA

General Provider Information

NPI Number	:	1548449135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANITA G CHAWLA M,D., M.P.H

Provider Business Mailing Address
First Line	:	1059 EL MONTE AVE
Second Line	:	SUITE B
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-2320
Country	:	US
Telephone Number	:	650-266-8213
Fax Number	:

Provider Business Practice Location Address
First Line	:	1059 EL MONTE AVE
Second Line	:	SUITE B
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-2320
Country	:	US
Telephone Number	:	650-266-8213
Fax Number	:

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

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	10/30/2007

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