Provider Demographics
NPI:1396239950
Name:CHAUBEY, PRAVIN
Entity type:Individual
Prefix:
First Name:PRAVIN
Middle Name:
Last Name:CHAUBEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5887 W CEDAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-3354
Mailing Address - Country:US
Mailing Address - Phone:405-637-5620
Mailing Address - Fax:
Practice Address - Street 1:5887 W CEDAR HILL RD
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84081-3354
Practice Address - Country:US
Practice Address - Phone:405-637-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies