Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC26692 | CA |
N | 111NR0200X | Radiology | DC26692 | CA |
N | 213ER0200X | Radiology | DC26692 | CA |
NPI | 1043438039 |
---|---|
Provider Name | Dr. Monisha Mona Chanan |
First Address | San Leandro, CA 94578 |
Second Address | San Leandro, CA 94578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 13/06/2011 |