Provider Demographics
NPI:1457472664
Name:APEX HEALTHCARE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:APEX HEALTHCARE MEDICAL CENTER INC
Other - Org Name:APEX FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALI
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHAUDHURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-672-3379
Mailing Address - Street 1:41889 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544
Mailing Address - Country:US
Mailing Address - Phone:951-652-8700
Mailing Address - Fax:951-492-4159
Practice Address - Street 1:28400 MCCALL BLVD STE B10
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92585-9658
Practice Address - Country:US
Practice Address - Phone:951-414-2020
Practice Address - Fax:951-414-2021
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APEX HEALTHCARE MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-03
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38313174400000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29818ZMedicare PIN