MEDICARE: MR. SUDARSHAN CHATTERJEE MD FACC

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	207RC0000X	Cardiovascular Disease Physician	53581	MA
2	207RI0011X	Interventional Cardiology Physician	C43324	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	201274943	OTHER		PRIVATE HEALTH SYSTEM
2	419452	OTHER		US FAMILY HEALTH
3	C43324	OTHER	CA	MEDICAL BOARD OF CALIFORNIA -DEPARTMENT OF CONSUMER AFFAIRS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	31496	OTHER		FALLON COMM HEALTH PLANS
6	981971	OTHER		NETWORK HEALTH PLAN
7	0014180	OTHER		NEIGHBORHOOD HEALTH PLAN
8	201274943	OTHER		FIRST HEALTH
9	2500732	OTHER		UNITED HEALTH CARE
10	J09303	OTHER		BCBS OF MASS
11	2500732	OTHER		EVERCARE
12	60560	OTHER		CIGNA
13	053581	OTHER		TUFTS HEALTH PLAN
14	0104615YPM01	OTHER		ANTHEM BLUE SHIELD
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	61066	OTHER		HARVARD PILGRIM
17	89673	OTHER		AETNA USHC HMO ONLY

General Provider Information

NPI Number	:	1750465712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SUDARSHAN CHATTERJEE MD FACC

Provider Business Mailing Address
First Line	:	5810 E TRAPPER TRL
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-4734
Country	:	US
Telephone Number	:	909-398-1503
Fax Number	:	909-398-4950

Provider Business Practice Location Address
First Line	:	4950 SAN BERNARDINO ST STE 208
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-2328
Country	:	US
Telephone Number	:	978-430-3082
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/21/2022

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