Individual
AVINASH CHENAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
489 E 21ST ST, SAN BERNARDINO, CA 92404
(909) 882-2973
(909) 882-2681
Mailing address
2278 ARDEMORE DR, FULLERTON, CA 92833-4819
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A139184
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0047351
—
CA
Enumeration date
07/06/2010
Last updated
09/18/2018
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