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General NPI Number Information
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NPI Number | 1235666108
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Entity Type | Organization
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Legal Business Name | CHARTER PROFESSIONAL GROUP INC
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 775 SUNRISE AVE STE 140
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City | ROSEVILLE
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State | CA
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Zip | 95661-4527
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Country | US
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Telephone | 916-784-1244
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Fax | 916-784-3949
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Provider Business Mailing Address
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Address Line | 775 SUNRISE AVE STE 140
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City | ROSEVILLE
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State | CA
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Zip | 95661-4527
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Country | US
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Telephone | 916-784-1244
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Fax | 916-784-3949
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Authorized Official
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Title or Position | OWNER
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Name | PAVITAR SINGH CHEEMA
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Credential | MD
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Telephone | 916-784-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A51362
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License Number State | CA
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