Provider Demographics
NPI:1144356445
Name:B. S. CHANDRASEKHAR, M. D., INC.
Entity type:Organization
Organization Name:B. S. CHANDRASEKHAR, M. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BALA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANDRASEKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-447-1092
Mailing Address - Street 1:255 E. SANTA CLARA ST.
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7233
Mailing Address - Country:US
Mailing Address - Phone:626-447-1092
Mailing Address - Fax:626-447-4125
Practice Address - Street 1:255 E. SANTA CLARA ST.
Practice Address - Street 2:SUITE 310
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7233
Practice Address - Country:US
Practice Address - Phone:626-447-1092
Practice Address - Fax:626-447-4125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40065208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W20468Medicare PIN