Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A79662 | CA |
NPI | 1104804475 |
---|---|
Provider Name | Mr. Pervaiz Akhtar Chaudhry |
First Address | Fresno, CA 93720-1545 |
Second Address | Fresno, CA 93720-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 25/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I09890 | (02) |