Healthcare Provider Details

I. General information

NPI: 1396747762
Provider Name (Legal Business Name): SHOVA HEALTHCARE VNA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27851 BRADLEY RD SUITE 125
SUN CITY CA
92586-2286
US

IV. Provider business mailing address

1545 W FLORIDA AVE
HEMET CA
92543-3814
US

V. Phone/Fax

Practice location:
  • Phone: 951-675-4829
  • Fax: 951-679-3944
Mailing address:
  • Phone: 951-791-1111
  • Fax: 951-925-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number250000225
License Number StateCA

VIII. Authorized Official

Name: DR. KALI P CHAUDHURI
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 951-791-1111