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General NPI Number Information
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NPI Number | 1851312268
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Entity Type | Individual
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Provider Name | JAYANTA CHOUDHURY MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/04/2012
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Provider Practice Location Address
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Address Line | 7015 N CHESTNUT AVE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93720-0349
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Country | US
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Telephone | 559-326-1010
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Fax | 559-326-1020
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Provider Business Mailing Address
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Address Line | 2823 FRESNO ST COMMUNITY REGIONAL MEDICAL,1ST FLOOR ENDOSCOPY SUITE
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City | FRESNO
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State | CA
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Zip | 93721-1324
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Country | US
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Telephone | 559-459-3882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A98988
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License Number State | CA
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