Individual
ANGEL CHANDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
1825 LIFETIME DR, MODESTO, CA 95355-2665
(209) 541-8722
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN687860
CA
Other
Enumeration date
02/13/2017
Last updated
06/30/2021
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