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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