Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A477470 | CA |
Y | 111NI0900X | Internist | A477470 | CA |
N | 207RG0300X | Geriatric Medicine | A47747 | CA |
NPI | 1053488114 |
---|---|
Provider Name | Dr. Chandan D S Cheema |
First Address | Fair Oaks, CA 95628-3171 |
Second Address | Fair Oaks, CA 95628-3171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 07/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0A477470 | MEDICAL (01) | CA |
F10868 | (02) | CA |