Provider Demographics
NPI:1982799490
Name:CHAUDHRI, MAHIPAL S (MD)
Entity Type:Individual
Prefix:
First Name:MAHIPAL
Middle Name:S
Last Name:CHAUDHRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:890 WESTFALL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2610
Mailing Address - Country:US
Mailing Address - Phone:585-442-6960
Mailing Address - Fax:585-442-3548
Practice Address - Street 1:8770 CUYAMACA ST STE 4
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4289
Practice Address - Country:US
Practice Address - Phone:619-596-9890
Practice Address - Fax:619-596-9893
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY196375101YM0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB1674OtherMEDICARE PTAN