Provider Demographics
NPI:1013905090
Name:CHAMAN L LUTHRA MD & ADARSH LUTHRA MD PC
Entity Type:Organization
Organization Name:CHAMAN L LUTHRA MD & ADARSH LUTHRA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONTIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-581-2600
Mailing Address - Street 1:2325 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8316
Mailing Address - Country:US
Mailing Address - Phone:928-782-4319
Mailing Address - Fax:928-782-1632
Practice Address - Street 1:2325 S AVENUE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8316
Practice Address - Country:US
Practice Address - Phone:928-782-4319
Practice Address - Fax:928-782-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0868340001Medicare NSC
AZZ104136Medicare PIN