Provider Demographics
NPI:1992375679
Name:CHOPRA, TANANSHI
Entity Type:Individual
Prefix:
First Name:TANANSHI
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 HARBOR BLVD STE B10
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1537
Mailing Address - Country:US
Mailing Address - Phone:714-786-6069
Mailing Address - Fax:714-834-9822
Practice Address - Street 1:3303 HARBOR BLVD STE B10
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1537
Practice Address - Country:US
Practice Address - Phone:714-786-6069
Practice Address - Fax:714-834-9822
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other