Healthcare Provider Details

I. General information

NPI: 1093135055
Provider Name (Legal Business Name): CHAROSKHON TURABOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N RIVERSIDE RD STE 150
SAINT JOSEPH MO
64507-2508
US

IV. Provider business mailing address

2895 N TOWNE AVE
POMONA CA
91767-2009
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-4025
  • Fax: 816-271-4026
Mailing address:
  • Phone: 909-982-2719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2025022536
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number2025022536
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2084D0003X
TaxonomyDiagnostic Neuroimaging (Psychiatry & Neurology) Physician
License NumberA175508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: