Healthcare Provider Details

I. General information

NPI: 1578313193
Provider Name (Legal Business Name): ASMA ASHA CHOWDHURY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 LINDEN WAY
ANTIOCH CA
94509-3166
US

IV. Provider business mailing address

1707 LINDEN WAY
ANTIOCH CA
94509-3166
US

V. Phone/Fax

Practice location:
  • Phone: 925-567-5766
  • Fax:
Mailing address:
  • Phone: 510-929-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number202460911191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: