Organization
CORWIN MEDICAL GROUP INC IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANMOHAN NAYYAR (PRESIDENT)
(760) 242-7777
Entity
Organization
Contact information
Practice address
19111 TOWN CENTER DR, APPLE VALLEY, CA 92308-8989
(760) 242-7777
(760) 242-0487
Mailing address
19111 TOWN CENTER DR, APPLE VALLEY, CA 92308-8989
(760) 242-7777
(760) 242-0487
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ22500Z
MEDICARE PTAN
CA
Enumeration date
07/20/2006
Last updated
11/23/2020
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