Provider Demographics
NPI:1104023340
Name:CHAUDHERY PEDIATRICS
Entity Type:Organization
Organization Name:CHAUDHERY PEDIATRICS
Other - Org Name:MOUNTAIN VIEW PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAT
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHAUDHERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-255-0500
Mailing Address - Street 1:PO BOX 34265
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4265
Mailing Address - Country:US
Mailing Address - Phone:702-255-0500
Mailing Address - Fax:702-821-1704
Practice Address - Street 1:2901 N TENAYA WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1404
Practice Address - Country:US
Practice Address - Phone:702-255-0500
Practice Address - Fax:702-821-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty