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General NPI Number Information
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NPI Number | 1821018433
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Entity Type | Organization
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Legal Business Name | CORWIN MEDICAL GROUP INC IPA
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 19111 TOWN CENTER DR
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City | APPLE VALLEY
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State | CA
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Zip | 92308-8989
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Country | US
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Telephone | 760-242-7777
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Fax | 760-242-0487
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Provider Business Mailing Address
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Address Line | 19111 TOWN CENTER DR
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City | APPLE VALLEY
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State | CA
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Zip | 92308-8989
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Country | US
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Telephone | 760-242-7777
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Fax | 760-242-0487
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANMOHAN NAYYAR
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Credential |
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Telephone | 760-242-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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