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General NPI Number Information
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NPI Number | 1396747762
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Entity Type | Organization
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Legal Business Name | SHOVA HEALTHCARE VNA, LLC
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 27851 BRADLEY RD SUITE 125
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City | SUN CITY
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State | CA
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Zip | 92586-2286
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Country | US
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Telephone | 951-675-4829
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Fax | 951-679-3944
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Provider Business Mailing Address
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Address Line | 1545 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92543-3814
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Country | US
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Telephone | 951-791-1111
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Fax | 951-925-3606
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. KALI P CHAUDHURI
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Credential | MD
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Telephone | 951-791-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 250000225
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License Number State | CA
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