Provider Demographics
NPI:1891875126
Name:CHAUDHRY, ABID NAZIR (DPM)
Entity type:Individual
Prefix:
First Name:ABID
Middle Name:NAZIR
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9068 WOODMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6403
Mailing Address - Country:US
Mailing Address - Phone:818-892-3196
Mailing Address - Fax:818-830-6700
Practice Address - Street 1:9068 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6403
Practice Address - Country:US
Practice Address - Phone:818-892-3196
Practice Address - Fax:818-830-6700
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4089213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E40890Medicaid
CA000E40890Medicaid
U67236Medicare UPIN