NPIMap

Organization Active NPI

Choice Medical Clinic, Inc.

  • Clinical Medical Laboratory
  • San Jose, CA
National Provider Identifier
1609950997
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CHOICE MEDICAL CLINIC, INC.
Practice address
2365 Montpelier Dr
San Jose, CA 95116-1614
Phone
(408) 272-9244
Fax
(408) 254-4596
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Liza Tapia Vaughan
Title
General Manager
Phone
(408) 995-0102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CA Primary

Addresses

Primary practice location

2365 Montpelier Dr
San Jose, CA 95116-1614

Mailing address

1834 Stone Ave
Suite 2B
San Jose, CA 95125-1306
Phone (408) 995-0102

Other identifiers 1

IdentifierTypeStateIssuer
LAB99074FMedicaidCA

Other names 1

  • CHOICE MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Choice Medical Clinic Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609950997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 STONE AVE",
            "address_2": "SUITE 2B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951251306",
            "telephone_number": "408-995-0102",
            "fax_number": "408-995-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 MONTPELIER DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161614",
            "telephone_number": "408-272-9244",
            "fax_number": "408-254-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAPIA VAUGHAN",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "408-995-0102"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB99074F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHOICE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.