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General NPI Number Information
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NPI Number | 1972762649
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Entity Type | Individual
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Provider Name | SANJAY CHAUDHARI O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 4825 TORRANCE BLVD SUITE 100
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City | TORRANCE
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State | CA
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Zip | 90503-4134
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Country | US
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Telephone | 310-937-6585
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Fax |
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Provider Business Mailing Address
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Address Line | 21006 WOOD AVE APT S
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City | TORRANCE
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State | CA
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Zip | 90503-4127
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13372
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License Number State | CA
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