Provider Demographics
NPI:1518924323
Name:CHOUDRY, MUNEEB ASIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNEEB
Middle Name:ASIM
Last Name:CHOUDRY
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 1:15611 POMERADO RD STE 400
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2437
Mailing Address - Country:US
Mailing Address - Phone:760-291-6650
Mailing Address - Fax:
Practice Address - Street 1:2125 CITRACADO PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4159
Practice Address - Country:US
Practice Address - Phone:760-740-2715
Practice Address - Fax:858-207-0004
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35172207RX0202X
CAC137304207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64004344Medicaid
KY000000369115OtherANTHEM PROVIDER NUMB
KY000030077GOtherHUMANA PROVIDER NUMB
KY8679448OtherCIGNA
IN200270820Medicaid
KYP00234355OtherRAIL ROAD MEDICARE
KY7659052OtherAETNA
KY000000369115OtherANTHEM PROVIDER NUMB
KYP00234355OtherRAIL ROAD MEDICARE
KYG99994Medicare UPIN
IN200270820Medicaid