Basic Information
| Provider Information | |||||||||
| NPI: | 1841550746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAUHAN | ||||||||
| FirstName: | PRACHI | ||||||||
| MiddleName: | SINGH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1144 NORMAN DR | ||||||||
| Address2: | SUITE 203B | ||||||||
| City: | MANTECA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953365925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2092396008 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1144 NORMAN DR | ||||||||
| Address2: | SUITE 203B | ||||||||
| City: | MANTECA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953365925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2092396008 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2012 | ||||||||
| LastUpdateDate: | 01/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A135216 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.