MEDICARE: PANKAJ CHOPRA MD

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	207Q00000X	Family Medicine Physician	41959	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z132121	OTHER	AZ	ARIZONA MEDICARE FARGO PART B

Other Identifiers

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

General Provider Information

NPI Number	:	1295838282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PANKAJ CHOPRA MD

Provider Business Mailing Address
First Line	:	16605 E PALISADES BLVD
Second Line	:	STE 150
City	:	FOUNTAIN HILLS
State	:	AZ
Zip	:	85268-3716
Country	:	US
Telephone Number	:	480-837-4300
Fax Number	:	480-837-8302

Provider Business Practice Location Address
First Line	:	16605 E PALISADES BLVD
Second Line	:	STE 150
City	:	FOUNTAIN HILLS
State	:	AZ
Zip	:	85268-3716
Country	:	US
Telephone Number	:	480-837-4300
Fax Number	:	480-837-8302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/07/2014

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Directions to “ PANKAJ CHOPRA MD” Practice Location

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