Healthcare Provider Details

I. General information

NPI: 1104389956
Provider Name (Legal Business Name): MALINI CHAUHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 N CIRCLE DR
COLORADO SPRINGS CO
80909-1160
US

IV. Provider business mailing address

5620 CUBBAGE DR
COLORADO SPRINGS CO
80924-2084
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-7321
  • Fax:
Mailing address:
  • Phone: 928-246-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0076288
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number68930
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: