Healthcare Provider Details

I. General information

NPI: 1407114762
Provider Name (Legal Business Name): RANJIV CHOUDHARY, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41210 11TH ST W SUITE G
PALMDALE CA
93551-1447
US

IV. Provider business mailing address

PO BOX 1838
LANCASTER CA
93539-1838
US

V. Phone/Fax

Practice location:
  • Phone: 661-274-1777
  • Fax: 661-274-2777
Mailing address:
  • Phone: 661-274-1777
  • Fax: 661-274-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE WHITE
Title or Position: OFFICE MANAGER
Credential:
Phone: 661-274-1777