Healthcare Provider Details

I. General information

NPI: 1558142414
Provider Name (Legal Business Name): COMPREHENSIVE MEDICINE APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 BOSWELL RD STE 245
CHULA VISTA CA
91914-3539
US

IV. Provider business mailing address

1880 E WASHINGTON ST
COLTON CA
92324-4621
US

V. Phone/Fax

Practice location:
  • Phone: 619-876-9982
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: YASHWANT CHAUDHRI
Title or Position: MD
Credential: MD
Phone: 619-876-9982