Basic Information
Provider Information
NPI: 1689752784
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARULANANDAN
FirstName: CHANDRAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1800 HARRISON ST FL 7
Address2:  
City: OAKLAND
State: CA
PostalCode: 946123429
CountryCode: US
TelephoneNumber: 5106256262
FaxNumber:  
Practice Location
Address1: 3000 LAS POSITAS RD
Address2:  
City: LIVERMORE
State: CA
PostalCode: 945519627
CountryCode: US
TelephoneNumber: 9252432600
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/02/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XG45221CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
00G45221005CA MEDICAID


Home