Healthcare Provider Details

I. General information

NPI: 1326084005
Provider Name (Legal Business Name): ZINAT ARA CHOUDHURY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11211 SEPULVEDA BLVD
MISSION HILLS CA
91345-1115
US

IV. Provider business mailing address

PO BOX 9602
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 818-365-9561
  • Fax:
Mailing address:
  • Phone: 818-837-5637
  • Fax: 818-837-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA83957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: