Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | A95210 | CA |
NPI | 1083799472 |
---|---|
Provider Name | Dr. Indira D Chandrasekar |
First Address | Fresno, CA 93720-4270 |
Second Address | Fresno, CA 93711-0262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |