Healthcare Provider Details

I. General information

NPI: 1831601996
Provider Name (Legal Business Name): DR. SEENA KETAN CHOKSHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 AVALON BLVD APT 351
LOS ANGELES CA
90011-5622
US

IV. Provider business mailing address

23121 BENT OAK RD
DIAMOND BAR CA
91765-3014
US

V. Phone/Fax

Practice location:
  • Phone: 323-802-0323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77820
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number77820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: