Individual
RANGRAM CHANDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
304 BANNER CT, SUITE 1, MODESTO, CA 95356-9194
(209) 572-2020
(209) 572-4000
Mailing address
PO BOX 576067, MODESTO, CA 95357-6067
(209) 572-2020
(209) 572-4000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A81157
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A811570
—
CA
01
—
CA134886
MEDICARE PTAN
—
Enumeration date
10/18/2005
Last updated
11/28/2014
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