Organization
CHOICE MEDICAL CLINIC, INC.
Active
Organization
CHOICE MEDICAL CLINIC, INC.
Active
Other names
Choice Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
LIZA TAPIA VAUGHAN (GENERAL MANAGER)
(408) 995-0101
Entity
Organization
Contact information
Practice address
1895 MOWRY AVE, SUITE 116, FREMONT, CA 94538-1737
(510) 792-3398
(510) 792-3951
Mailing address
1834 STONE AVE, SUITE 2B, SAN JOSE, CA 95125-1306
(408) 995-0102
(408) 995-0190
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB98720F
—
CA
Enumeration date
10/24/2006
Last updated
08/22/2020
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