Provider Demographics
NPI:1093135055
Name:TURABOVA, CHAROSKHON
Entity Type:Individual
Prefix:
First Name:CHAROSKHON
Middle Name:
Last Name:TURABOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2895 N TOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2009
Mailing Address - Country:US
Mailing Address - Phone:909-982-2719
Mailing Address - Fax:
Practice Address - Street 1:2895 N TOWNE AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2009
Practice Address - Country:US
Practice Address - Phone:909-982-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1755082084D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic NeuroimagingGroup - Multi-Specialty