Provider Demographics
NPI:1043258429
Name:CHAUDHRI, YASHWANT S (MD)
Entity Type:Individual
Prefix:
First Name:YASHWANT
Middle Name:S
Last Name:CHAUDHRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8770 CUYAMACA ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4289
Mailing Address - Country:US
Mailing Address - Phone:619-596-9890
Mailing Address - Fax:619-596-9893
Practice Address - Street 1:8770 CUYAMACA ST STE 4
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071
Practice Address - Country:US
Practice Address - Phone:619-596-9890
Practice Address - Fax:619-596-9893
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA676792084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG94120Medicare UPIN
CAWA67679AMedicare ID - Type Unspecified
CAY09884Medicare UPIN