Provider Demographics
NPI:1699977314
Name:RUDRARAJU, CHANDRAKALA (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRAKALA
Middle Name:
Last Name:RUDRARAJU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHANDRAKALA
Other - Middle Name:
Other - Last Name:RUDRARAJU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4580 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1104
Mailing Address - Country:US
Mailing Address - Phone:661-327-4411
Mailing Address - Fax:661-616-9632
Practice Address - Street 1:4580 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1104
Practice Address - Country:US
Practice Address - Phone:661-327-4411
Practice Address - Fax:661-616-9632
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08184700207QG0300X
CAA103562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine