Choice Providers Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A36588 Issued in CA

Legal business name

CHOICE PROVIDERS MEDICAL GROUP INC

Doing business as

Noble Community Medical Assocaites

Practice address

17750 Sherman Way
Ste 101
Reseda, CA 91335-3380

Phone

(818) 705-7200

Fax

(818) 343-0805

NPI assigned

Jul 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hany Malek, DC

Title

Secretary

Phone

(818) 705-7200

Specialties & licenses 15

Addresses

Other identifiers 14

Other names 1

• Noble Community Medical Assocaites Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael M Koshak, MD

  • Family Medicine Physician
  • North Hollywood, CA
  • NPI 1689680696
  Medicare reassignment NPD
• Claudia L. Carcamo, P.A..

  • Medical Physician Assistant
  • Granada Hills, CA
  • NPI 1447439609
  Medicare reassignment
• Yarom Alex Eloul, PA-C, MPAS

  • Physician Assistant
  • North Hollywood, CA
  • NPI 1518127729
  Medicare reassignment
• Loren Yui Chen, M.D.

  • Internal Medicine Physician
  • Panorama City, CA
  • NPI 1972581643
  NPD
• David Enrique Cantong, DC

  • Chiropractor
  • Los Angeles, CA
  • NPI 1942216536
  NPD (past)
• Gerald Grega, DC

  • Chiropractor
  • Inglewood, CA
  • NPI 1003821471
  NPD (past)
• Kamiar Riahi, DC

  • Chiropractor
  • North Hollywood, CA
  • NPI 1073529863
  NPD (past)
• Behrooz Samouha, DC

  • Chiropractor
  • Inglewood, CA
  • NPI 1265620298
  NPD (past)
• Michael S. Stephens, D.C.

  • Chiropractor
  • Tyler, TX
  • NPI 1396835591
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1114947058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17750 SHERMAN WAY",
            "address_2": "STE 101",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353380",
            "telephone_number": "818-705-7200",
            "fax_number": "818-343-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17750 SHERMAN WAY",
            "address_2": "STE 101",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353380",
            "telephone_number": "818-705-7200",
            "fax_number": "818-343-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE PROVIDERS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "MALEK",
        "authorized_official_first_name": "HANY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "818-705-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21916",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28504",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20140",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20098",
            "primary": false
        },
        {
            "code": "173F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Sleep Specialist, PhD",
            "state": "CA",
            "license": "173F00000X",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A36588",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A35585",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A64420",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A44927",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C30241",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C31379",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A25062",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A54207",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G78404",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13428",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (RESEDA)",
            "identifier": "ZZZ50145Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (INGLEWOOD)",
            "identifier": "ZZZ50147Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (S.B.)",
            "identifier": "ZZZ50174Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (C.P)",
            "identifier": "ZZZ50176Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (G.H.)",
            "identifier": "ZZZ501722Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (EL MONTE)",
            "identifier": "ZZZ50172Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (PASADENA)",
            "identifier": "ZZZ50173Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102431",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102433",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD (L.A.)",
            "identifier": "ZZZ50146Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102434",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD",
            "identifier": "ZZZ501752",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102430",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102432",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noble Community Medical Assocaites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aisha Tenaiya-Anne Chason
• Jeanette Christine Chavez
• Shia Cheung
• Child Development Institute
• Jonathan Hyun Cho, DDS
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• Ariana Noelle Chrisman
• Christopher Otiko
• Cisco Medical Group, Inc (Cisco Medical Group - Reseda)
• City Dental Group

• Family Medicine Physician in Reseda, CA
• Providers in Reseda, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.