Healthcare Provider Details

I. General information

NPI: 1194964361
Provider Name (Legal Business Name): CHOICE HEALTHCARE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18564 US HIGHWAY 18 # 103104
APPLE VALLEY CA
92307-2312
US

IV. Provider business mailing address

19111 TOWN CENTER DR
APPLE VALLEY CA
92308-8989
US

V. Phone/Fax

Practice location:
  • Phone: 760-242-9262
  • Fax: 760-242-9264
Mailing address:
  • Phone: 760-242-7777
  • Fax: 888-847-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MANMOHAN NAYYAR
Title or Position: PRESIDENT
Credential: MD
Phone: 760-242-7777