Provider Demographics
NPI:1093816738
Name:CHOPRA, RAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12555 GARDEN GROVE BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1903
Mailing Address - Country:US
Mailing Address - Phone:714-638-0232
Mailing Address - Fax:714-638-0821
Practice Address - Street 1:12555 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1903
Practice Address - Country:US
Practice Address - Phone:714-638-0232
Practice Address - Fax:714-638-0821
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32763208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GR0025270Medicare ID - Type Unspecified
C35366Medicare UPIN