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NPI Code Detail

MEDICARE: CHANDAN DS CHEEMA MD INC

MEDICARE: CHANDAN DS CHEEMA MD 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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician
2207R00000XInternal Medicine Physician00A47747CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ05271ZOTHERCAGROUP PTAN

General Provider Information

NPI Number : 1598965667
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANDAN DS CHEEMA MD INC
Provider Business Mailing Address
First Line : 6608 MERCY CT STE B
Second Line :
City : FAIR OAKS
State : CA
Zip : 95628-3171
Country : US
Telephone Number : 916-241-9844
Fax Number : 916-241-9845
Provider Business Practice Location Address
First Line : 6608 MERCY CT STE B
Second Line :
City : FAIR OAKS
State : CA
Zip : 95628-3171
Country : US
Telephone Number : 916-241-9844
Fax Number : 916-241-9845
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHANDAN DEEP SINGH CHEEMA
Credential : MD
Telephone Number : 916-241-9844
Provider Enumeration Date : 07/18/2007
Last Update Date : 04/12/2021

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