Provider Demographics
NPI:1457634628
Name:CHAUHAN, CHRIS RAJ (MD)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:RAJ
Last Name:CHAUHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 PASEO CAMARILLO
Mailing Address - Street 2:APT 203
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5986
Mailing Address - Country:US
Mailing Address - Phone:805-402-8820
Mailing Address - Fax:
Practice Address - Street 1:480 PASEO CAMARILLO
Practice Address - Street 2:APT 203
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-402-8820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125412207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA125412OtherNONE