Provider Demographics
NPI:1194754374
Name:CHAUDRY, BHARAT B (MD)
Entity type:Individual
Prefix:DR
First Name:BHARAT
Middle Name:B
Last Name:CHAUDRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 E TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3328
Mailing Address - Country:US
Mailing Address - Phone:213-253-2677
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0016910OtherGROUP MEDICAID
CAGR0100430OtherGROUP MEDICAL
CA1902846306OtherGROUP NPI
CA00A498850OtherBLUE SHIELD
CACE1617OtherGROUP RAILROAD MEDICARE
CAW18762OtherGROUP MEDICARE
CA00A498850Medicaid
CA110117175OtherRAILROAD MEDICARE
CA1356390009OtherGROUP NPI
CAW11675OtherGROUP MEDICARE
CAWA49885BMedicare PIN
CA00A498850Medicaid