Provider Demographics
NPI:1629172291
Name:CHOPRA, DEVIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9049 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-9999
Mailing Address - Country:US
Mailing Address - Phone:562-949-9589
Mailing Address - Fax:562-942-8204
Practice Address - Street 1:9049 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-9999
Practice Address - Country:US
Practice Address - Phone:562-949-9589
Practice Address - Fax:562-942-8204
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4108213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E4108Medicaid
CA000E4108Medicaid
CA5767880001Medicare NSC
CAE4108Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER