Healthcare Provider Details

I. General information

NPI: 1013905090
Provider Name (Legal Business Name): CHAMAN L LUTHRA MD & ADARSH LUTHRA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S AVENUE A
YUMA AZ
85364-8316
US

IV. Provider business mailing address

2325 S AVENUE A
YUMA AZ
85364-8316
US

V. Phone/Fax

Practice location:
  • Phone: 928-782-4319
  • Fax: 928-782-1632
Mailing address:
  • Phone: 928-782-4319
  • Fax: 928-782-1632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANDREA ONTIVEROS
Title or Position: OFFICE MANAGER
Credential:
Phone: 928-581-2600