Provider Demographics
NPI:1215042882
Name:JANAK R. CHOPRA M.D.INC.
Entity Type:Organization
Organization Name:JANAK R. CHOPRA M.D.INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANAK
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHOPRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-638-0232
Mailing Address - Street 1:12555 GARDEN GROVE BLVD
Mailing Address - Street 2:#404
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1902
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:#404
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1902
Practice Address - Country:US
Practice Address - Phone:714-638-0232
Practice Address - Fax:714-638-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-O29855261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA29855Medicare PIN