Provider Demographics
NPI:1598715476
Name:CHANDRASHEKAR, NARENDRA SHASHIBUSHAN (MD)
Entity type:Individual
Prefix:MR
First Name:NARENDRA
Middle Name:SHASHIBUSHAN
Last Name:CHANDRASHEKAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:81719 DOCTOR CARREON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5518
Mailing Address - Country:US
Mailing Address - Phone:760-347-0707
Mailing Address - Fax:760-347-3378
Practice Address - Street 1:81719 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5518
Practice Address - Country:US
Practice Address - Phone:760-347-0707
Practice Address - Fax:760-347-3378
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2012-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA77917207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A779170Medicaid
CAH65227Medicare UPIN
CA00A779170Medicare ID - Type Unspecified