Provider Demographics
NPI:1831319326
Name:CHOPRA, SHAMIT (MBBS, MS)
Entity Type:Individual
Prefix:DR
First Name:SHAMIT
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:MBBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 TRUXEL RD APT 915
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3740
Mailing Address - Country:US
Mailing Address - Phone:203-312-4693
Mailing Address - Fax:
Practice Address - Street 1:2521 STOCKTON BLVD STE 7200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2207
Practice Address - Country:US
Practice Address - Phone:916-734-6581
Practice Address - Fax:916-703-5011
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF5383207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ05076ZOtherMEDICARE LEGACY