Organization Active NPI

Chandnish K Ahluwalia M D Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Glendale, CA
National Provider Identifier
1013901974
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
CHANDNISH K AHLUWALIA M D INC
Practice address
1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone
(818) 952-2286
Fax
(818) 952-2274
NPI assigned
Sep 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chandnish K Ahluwalia, M.D.NPI 1508850421
Title
President
Phone
(818) 952-2286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1812 Verdugo Blvd
Glendale, CA 91208-1407

Mailing address

1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone (818) 790-7100

Other identifiers 1

IdentifierTypeStateIssuer
00A449030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090826000653 CA Part B Supplier - Clinic/Group Practice 1355496431 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1013901974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 VERDUGO BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081407",
            "telephone_number": "818-790-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 VERDUGO BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081407",
            "telephone_number": "818-952-2286",
            "fax_number": "818-952-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDNISH K AHLUWALIA M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "AHLUWALIA",
        "authorized_official_first_name": "CHANDNISH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-952-2286",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A449030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.