Provider Demographics
NPI:1720173412
Name:CHOPRA, SAWTANTRA KUMAR (MD)
Entity Type:Individual
Prefix:MR
First Name:SAWTANTRA
Middle Name:KUMAR
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SPANOS COURT
Mailing Address - Street 2:SUITE 128
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355
Mailing Address - Country:US
Mailing Address - Phone:209-525-3112
Mailing Address - Fax:209-525-3126
Practice Address - Street 1:1401 SPANOS COURT
Practice Address - Street 2:SUITE 128
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-525-3112
Practice Address - Fax:209-525-3126
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA297711207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A25873Medicare UPIN