Basic Information
Provider Information
NPI: 1407968662
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOPRA
FirstName: SUMAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5 CENTERPOINTE DR
Address2:  
City: LA PALMA
State: CA
PostalCode: 906231050
CountryCode: US
TelephoneNumber: 8885050043
FaxNumber: 6264056768
Practice Location
Address1: 5 CENTERPOINTE DR
Address2:  
City: LA PALMA
State: CA
PostalCode: 906231050
CountryCode: US
TelephoneNumber: 8885050043
FaxNumber: 6264056768
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XA89498CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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