Individual provider Active NPI

Swarna Sundari Chanduri, MD

  • Hematology & Oncology Physician
  • Pomona, CA
National Provider Identifier
1629050489
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A41753 Issued in CA
Practice address
1910 Royalty Drive
Pomona, CA 91767-7205
Phone
(909) 630-7205
Fax
(909) 630-7380
NPI assigned
Nov 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A41753 CA Primary

Addresses

Primary practice location

1910 Royalty Drive
Pomona, CA 91767-7205

Mailing address

840 Towne Center Drive
Pomona, CA 91767-5900
Phone (909) 398-1550

Other identifiers 1

IdentifierTypeStateIssuer
00A417530MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090827000820 CA Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Hematology/Oncology 2062322951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology, Hospice/Palliative Care
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1910 Royalty Dr
Pomona, CA 91767-3021
Phone (909) 630-7205

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A41753CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Chino Medical Group, Inc Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Behnam Ebrahimi MD Inc Hematology & Oncology Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1629050489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DRIVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROYALTY DRIVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917677205",
            "telephone_number": "909-630-7205",
            "fax_number": "909-630-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDURI",
        "first_name": "SWARNA",
        "middle_name": "SUNDARI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A41753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A417530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.