Provider Demographics
NPI:1386782860
Name:HARICHANDRAN, CHELVADURAI HEMA (MD)
Entity type:Individual
Prefix:DR
First Name:CHELVADURAI
Middle Name:HEMA
Last Name:HARICHANDRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 QUAIL CT STE 204
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5569
Mailing Address - Country:US
Mailing Address - Phone:925-947-5663
Mailing Address - Fax:925-472-0254
Practice Address - Street 1:39 QUAIL CT STE 204
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5569
Practice Address - Country:US
Practice Address - Phone:925-947-5663
Practice Address - Fax:925-472-0254
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC402272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C402270Medicaid
CAG06850Medicare UPIN
CA00C402270Medicare ID - Type Unspecified