Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 150807 | CA |
NPI | 1013371046 |
---|---|
Provider Name | Dr. Jerome Chelliah |
First Address | Santa Clara, CA 95051 |
Second Address | Santa Clara, CA 95051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2016 |
Last Update Date | 18/03/2020 |