Provider Demographics
NPI:1356928105
Name:HEALTHCHOICE PRIMARY CARE INC
Entity type:Organization
Organization Name:HEALTHCHOICE PRIMARY CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NGOC
Authorized Official - Middle Name:X
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-290-1800
Mailing Address - Street 1:10737 CAMINO RUIZ STE 143
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2361
Mailing Address - Country:US
Mailing Address - Phone:858-290-1800
Mailing Address - Fax:
Practice Address - Street 1:10737 CAMINO RUIZ STE 143
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-2361
Practice Address - Country:US
Practice Address - Phone:619-776-5295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty