Individual
MR. CHETAN KRISHNA GAIROLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14011 PARK AVE, VICTORVILLE, CA 92392-2413
(888) 750-0036
(860) 533-6571
Mailing address
393 E WALNUT ST, PASADENA, CA 91188-0001
(860) 533-6559
(860) 533-6571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A-14483
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2013
Last updated
12/08/2021
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