Provider Demographics
NPI:1558554634
Name:CHABRA, BASHAMBER N (MD)
Entity Type:Individual
Prefix:DR
First Name:BASHAMBER
Middle Name:N
Last Name:CHABRA
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 1:3540 WILSHIRE BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2349
Mailing Address - Country:US
Mailing Address - Phone:213-480-3190
Mailing Address - Fax:213-248-0318
Practice Address - Street 1:3540 WILSHIRE BLVD STE 501
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2349
Practice Address - Country:US
Practice Address - Phone:213-480-3190
Practice Address - Fax:213-248-0318
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC38745208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice