Chandrashekar Medical Corporation

Organization Active NPI Nephrology Physician · Indio, CA

NPI 1124102314 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1124102314
Entity type
Organization (NPI type 2)
Primary specialty
Nephrology Physician 207RN0300X
Legal business name
CHANDRASHEKAR MEDICAL CORPORATION
Practice address
81-715 Dr. Carreon Blvd
Ste B2
Indio, CA 92201
Phone
(760) 347-8181
Fax
(760) 775-2899
NPI assigned
Oct 24, 2006
Organization subpart
No

Authorized official

Name
Sue Shinn
Title
Office Manager
Phone
(760) 342-8898

Practitioners 6

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RN0300X Yes

Addresses

Primary practice location

81-715 Dr. Carreon Blvd
Ste B2
Indio, CA 92201

Mailing address

81-719 Dr. Carreon Blvd
Ste 2a
Indio, CA 92201-5518
Phone (760) 342-8898

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124102314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81-719 DR. CARREON BLVD",
            "address_2": "STE 2A",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015518",
            "telephone_number": "760-342-8898",
            "fax_number": "760-342-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81-715 DR. CARREON BLVD",
            "address_2": "STE B2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "92201",
            "telephone_number": "760-347-8181",
            "fax_number": "760-775-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDRASHEKAR MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHINN",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "760-342-8898"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

All providers in Indio, CA · Nephrology Physician in California

Sources for this page

Verify at the official NPI Registry.