MEDICARE: G S CHOPRA CHTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician
2	2084N0400X	Neurology Physician	8963	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104861277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G S CHOPRA CHTD.

Provider Business Mailing Address
First Line	:	6410 MEDICAL CENTER ST STE A100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-2445
Country	:	US
Telephone Number	:	702-796-8500
Fax Number	:	702-796-8502

Provider Business Practice Location Address
First Line	:	6410 MEDICAL CENTER ST STE A100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-796-8500
Fax Number	:	702-796-8502

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	CHRISTINA WHITE
Credential	:
Telephone Number	:	702-796-8500

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	03/13/2019

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Directions to “G S CHOPRA CHTD. ” Practice Location

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