Provider Demographics
NPI:1811148224
Name:CHAUDHARI, PARU R (MD)
Entity type:Individual
Prefix:DR
First Name:PARU
Middle Name:R
Last Name:CHAUDHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LA CASA VIA STE 101
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3092
Mailing Address - Country:US
Mailing Address - Phone:925-722-6500
Mailing Address - Fax:
Practice Address - Street 1:120 LA CASA VIA STE 101
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3092
Practice Address - Country:US
Practice Address - Phone:925-722-6500
Practice Address - Fax:925-386-7680
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267800207N00000X
STUDENT390200000X
CAA109338207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program