Provider Demographics
NPI:1487712790
Name:THAKUR, CHAHAT (MD)
Entity type:Individual
Prefix:
First Name:CHAHAT
Middle Name:
Last Name:THAKUR
Suffix:
Gender:F
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:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92286-1600
Mailing Address - Country:US
Mailing Address - Phone:760-567-6545
Mailing Address - Fax:
Practice Address - Street 1:35400 BOB HOPE DR STE 204
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1774
Practice Address - Country:US
Practice Address - Phone:760-228-1114
Practice Address - Fax:760-228-2066
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine