Provider Demographics
NPI:1639401987
Name:CHOICE PHYSICIANS NETWORK, INC.
Entity Type:Organization
Organization Name:CHOICE PHYSICIANS NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANMOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-242-7777
Mailing Address - Street 1:19111 TOWN CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308
Mailing Address - Country:US
Mailing Address - Phone:760-242-7777
Mailing Address - Fax:760-242-0487
Practice Address - Street 1:19111 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-8989
Practice Address - Country:US
Practice Address - Phone:760-242-7777
Practice Address - Fax:760-242-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization