Individual
AMITABH SHANISH CHAUHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1135 S SUNSET AVE, #100, WEST COVINA, CA 91790-3937
(626) 960-8614
(626) 960-8624
Mailing address
2394 SLOAN DR, LA VERNE, CA 91750-1352
(909) 596-2274
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A62209
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A622090
—
CA
Enumeration date
05/05/2006
Last updated
12/02/2021
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