Healthcare Provider Details

I. General information

NPI: 1336115781
Provider Name (Legal Business Name): CHOCOMA S DAROCHA P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 K ST NW STE 707
WASHINGTON DC
20037-1810
US

IV. Provider business mailing address

6255 W SUNSET BLVD FL 21
LOS ANGELES CA
90028-7422
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-8680
  • Fax: 202-293-8694
Mailing address:
  • Phone: 323-860-5200
  • Fax: 323-467-7119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA031384
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: