Healthcare Provider Details

I. General information

NPI: 1801829841
Provider Name (Legal Business Name): SATISH CHOUDHARY M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E ARTESIA ST SUITE 255
POMONA CA
91767-2900
US

IV. Provider business mailing address

160 E ARTESIA ST SUITE 255
POMONA CA
91767-2900
US

V. Phone/Fax

Practice location:
  • Phone: 909-620-0900
  • Fax: 909-620-1395
Mailing address:
  • Phone: 909-620-0900
  • Fax: 909-620-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA44578
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberA44578
License Number StateCA

VIII. Authorized Official

Name: SATISH CHOUDHARY
Title or Position: PRESIDENT
Credential: MD
Phone: 909-620-0900