Healthcare Provider Details

I. General information

NPI: 1811038839
Provider Name (Legal Business Name): CHOICE HEALTHCARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2007
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 WEST MAIN STREET SUITE 110
BARSTOW CA
92311
US

IV. Provider business mailing address

19111 TOWN CENTER DR
APPLE VALLEY CA
92308-8989
US

V. Phone/Fax

Practice location:
  • Phone: 760-256-1422
  • Fax:
Mailing address:
  • Phone: 760-242-7777
  • Fax:

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:
Phone: 760-242-7777