Provider Demographics
NPI:1669730354
Name:COMMUNITY PULMONARY ASSOCIATES, INC.
Entity type:Organization
Organization Name:COMMUNITY PULMONARY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:CHITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDASWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:559-326-7659
Mailing Address - Street 1:1243 E SPRUCE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3379
Mailing Address - Country:US
Mailing Address - Phone:559-326-7659
Mailing Address - Fax:559-326-7498
Practice Address - Street 1:1243 E SPRUCE AVE STE 104
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3379
Practice Address - Country:US
Practice Address - Phone:559-326-7659
Practice Address - Fax:559-326-7498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAL46499Medicare UPIN
CA00A929810Medicare PIN