Provider Demographics
NPI:1659265122
Name:CHAND, AVISHEK (RN)
Entity type:Individual
Prefix:
First Name:AVISHEK
Middle Name:
Last Name:CHAND
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15728 ROAD 29 1/2 # A
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-2005
Mailing Address - Country:US
Mailing Address - Phone:408-318-7637
Mailing Address - Fax:
Practice Address - Street 1:15728 ROAD 29 1/2
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-2005
Practice Address - Country:US
Practice Address - Phone:408-665-9623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01150839163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse