Provider Demographics
NPI:1609109990
Name:CHOPRA, CHARU (DPT)
Entity Type:Individual
Prefix:
First Name:CHARU
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14287 N 87TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3698
Mailing Address - Country:US
Mailing Address - Phone:602-329-8250
Mailing Address - Fax:480-565-1898
Practice Address - Street 1:3540 E BASELINE RD STE 103
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-9628
Practice Address - Country:US
Practice Address - Phone:602-243-1476
Practice Address - Fax:602-243-1010
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8784225100000X
AZ8784PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ487418Medicaid