Digestive Care, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

C55292 Issued in CA

Legal business name

DIGESTIVE CARE, LLC

Practice address

243 Green Valley Rd
Suite E
Freedom, CA 95019-3133

Phone

(831) 728-1410

Fax

(831) 728-2076

NPI assigned

Aug 22, 2008

Last updated

May 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prathibha Chandrasekaran, M.D.

Title

President

Phone

(831) 728-1410

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1376790238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD",
            "address_2": "SUITE E",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-728-1410",
            "fax_number": "831-728-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD",
            "address_2": "SUITE E",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-728-1410",
            "fax_number": "831-728-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "CHANDRASEKARAN",
        "authorized_official_first_name": "PRATHIBHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-728-1410",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C55292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8607001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Freedom, CA
• Providers in Freedom, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.