Provider Demographics
NPI:1083391775
Name:CHOEGYEL, SONAM CHODON (NP)
Entity Type:Individual
Prefix:
First Name:SONAM
Middle Name:CHODON
Last Name:CHOEGYEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 CLARITA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6269
Mailing Address - Country:US
Mailing Address - Phone:510-517-5613
Mailing Address - Fax:
Practice Address - Street 1:2121 HARRISON ST STE 120
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3788
Practice Address - Country:US
Practice Address - Phone:510-587-3000
Practice Address - Fax:510-587-3003
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty