Healthcare Provider Details

I. General information

NPI: 1962692236
Provider Name (Legal Business Name): SALMA K CHAUDHRI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1246 E ARROW HWY STE A
UPLAND CA
91786-4955
US

IV. Provider business mailing address

1246 E ARROW HWY STE A
UPLAND CA
91786-4955
US

V. Phone/Fax

Practice location:
  • Phone: 909-931-9675
  • Fax: 909-581-6277
Mailing address:
  • Phone: 909-931-9675
  • Fax: 909-581-6277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA112451
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD040298
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberA112451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: