Organization
CHABOT UROLOGY MEDICAL ASSOCIATES, A PROFESSIONAL CORP.
Active
Other names
Chabot Urology Medcal Associates, A Professional Corp., Chabot Urology Medical Associates , A Professional Corporation, Chabot Urology Medical Associates, A Professional Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOURJYA PRAKASH MISRA M.D. (PRESIDENT)
(510) 889-9166
Entity
Organization
Contact information
Practice address
20055 LAKE CHABOT RD STE 310, CASTRO VALLEY, CA 94546-5334
(510) 889-9166
Mailing address
20055 LAKE CHABOT RD STE 310, CASTRO VALLEY, CA 94546-5334
(510) 889-9166
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A49141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E85288
—
CA
Enumeration date
01/27/2007
Last updated
07/11/2023
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