Provider Demographics
NPI:1659842060
Name:MIRAMONTES-CHAUDHARY, LAURA (ND)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MIRAMONTES-CHAUDHARY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 TRADE ST STE 160
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2324
Mailing Address - Country:US
Mailing Address - Phone:858-646-0400
Mailing Address - Fax:858-646-0402
Practice Address - Street 1:7220 TRADE ST STE 160
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2324
Practice Address - Country:US
Practice Address - Phone:858-646-0400
Practice Address - Fax:858-646-0402
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1047175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath