Individual
CHANDRA S MOHANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP,BOCO,FAAOP
Contact information
Practice address
400 SHADOW LN STE 110, LAS VEGAS, NV 89106-4355
(702) 800-6520
(702) 800-6492
Mailing address
1043 ELM AVE STE 202, LONG BEACH, CA 90813-3244
(562) 432-2987
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
10/03/2007
Last updated
03/09/2022
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