Provider Demographics
NPI:1760423669
Name:CHAUDHRY, MOHAMMAD ASIF (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ASIF
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 E BEVERLY BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4317
Mailing Address - Country:US
Mailing Address - Phone:323-722-2260
Mailing Address - Fax:323-722-2130
Practice Address - Street 1:101 E BEVERLY BLVD
Practice Address - Street 2:STE 401
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4317
Practice Address - Country:US
Practice Address - Phone:323-722-2260
Practice Address - Fax:323-722-2130
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA54998207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA54998OtherSTATE LICENSE #
CAA54998OtherSTATE LICENSE #
CAWA54998BMedicare PIN