NPIMap

Organization Active NPI

Choice Medical Clinic, Inc

Doing business as Choice Medical Group

  • Gynecology Physician
  • Concord, CA
National Provider Identifier
1760579833
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
GR0006548 Issued in CA
Legal business name
CHOICE MEDICAL CLINIC, INC
Doing business as
Choice Medical Group
Practice address
2485 High School Ave
Suite 227
Concord, CA 94520-1819
Phone
(925) 682-2131
Fax
(925) 676-7411
NPI assigned
Oct 9, 2006
Last updated
Sep 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X GR0006548 CA Primary

Addresses

Primary practice location

2485 High School Ave
Suite 227
Concord, CA 94520-1819

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
GR0006548MedicaidCA

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.

Locations

2485 High School Ave
Ste 227
Concord, CA 94520
Phone (925) 682-2131

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1760579833",
    "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": "2485 HIGH SCHOOL AVE",
            "address_2": "SUITE 227",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201819",
            "telephone_number": "925-682-2131",
            "fax_number": "925-676-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "TAPIA VAUGHAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "408-995-0102"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "GR0006548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0006548",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHOICE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.