Provider Demographics
NPI:1164619912
Name:CHANDRA, PREETI ABHINAV (MD)
Entity type:Individual
Prefix:DR
First Name:PREETI
Middle Name:ABHINAV
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PREETI
Other - Middle Name:SATISH
Other - Last Name:PEDNEKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2400 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7170
Mailing Address - Country:US
Mailing Address - Phone:928-344-2000
Mailing Address - Fax:
Practice Address - Street 1:1951 W 25TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6925
Practice Address - Country:US
Practice Address - Phone:928-336-1675
Practice Address - Fax:928-336-1676
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51909207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03489741Medicaid
NY03489741Medicaid