Healthcare Provider Details

I. General information

NPI: 1639455462
Provider Name (Legal Business Name): SANJAY CHAUHAN MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 E SUSSEX WAY STE 107
FRESNO CA
93726-4035
US

IV. Provider business mailing address

2407 E SUSSEX WAY STE 107
FRESNO CA
93726-4035
US

V. Phone/Fax

Practice location:
  • Phone: 559-244-0955
  • Fax: 559-244-0912
Mailing address:
  • Phone: 559-244-0955
  • Fax: 559-244-0912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberA50709
License Number StateCA

VIII. Authorized Official

Name: DR. SANJAY JOSEPH CHAUHAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 559-244-0955