Provider Demographics
NPI:1629261151
Name:CHOHAN, FARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:FARIA
Middle Name:
Last Name:CHOHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 S GLENDORA AVE
Mailing Address - Street 2:SUITE #106
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3066
Mailing Address - Country:US
Mailing Address - Phone:626-856-3317
Mailing Address - Fax:
Practice Address - Street 1:450 S GLENDORA AVE
Practice Address - Street 2:SUITE #106
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3066
Practice Address - Country:US
Practice Address - Phone:626-856-3317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD56077Medicaid