Provider Demographics
NPI:1811038839
Name:CHOICE HEALTHCARE ASSOCIATES INC
Entity Type:Organization
Organization Name:CHOICE HEALTHCARE ASSOCIATES INC
Other - Org Name:CHOICE HEALTHCARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANMOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-242-7777
Mailing Address - Street 1:19111 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-8989
Mailing Address - Country:US
Mailing Address - Phone:760-242-7777
Mailing Address - Fax:
Practice Address - Street 1:1890 WEST MAIN STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311
Practice Address - Country:US
Practice Address - Phone:760-256-1422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEX218AOtherPTAN