Provider Demographics
NPI:1528194818
Name:PATIENTS CHOICE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:PATIENTS CHOICE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-624-8138
Mailing Address - Street 1:9645 MONTE VISTA AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2236
Mailing Address - Country:US
Mailing Address - Phone:909-624-8138
Mailing Address - Fax:
Practice Address - Street 1:9645 MONTE VISTA AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2236
Practice Address - Country:US
Practice Address - Phone:909-624-8138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A533080Medicare ID - Type Unspecified
CAG21497Medicare UPIN