Gangadarshni Chandramohan, M.D.

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

A51443 Issued in CA

Practice address

12021 Wilmington Ave
Los Angeles, CA 90059-3019

Phone

(310) 668-4653

Fax

(310) 668-8715

NPI assigned

Jan 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750351300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 CUMBERLAND RD",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082105",
            "telephone_number": "626-583-9161",
            "fax_number": "626-432-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-668-4653",
            "fax_number": "310-668-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRAMOHAN",
        "first_name": "GANGADARSHNI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CA",
            "license": "A51443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Zabren Chandler, LCSW
• Stebbins Chandor, M.D.
• Heena J Chandra
• Jesslyn Chrestella Chandra
• Ambika Chandramohan
• Brindha Chandran
• Inggrid Chandranata, ND
• Sukantha Chandrasekaran, PHD, D(ABMM)
• Janak Chandrasoma, M.D.
• Shahin Tissa Chandrasoma, MD

• Pediatric Nephrology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.