Provider Demographics
NPI:1215294160
Name:FIRST CHOICE PHYSICIAN PARTNERS
Entity type:Organization
Organization Name:FIRST CHOICE PHYSICIAN PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-428-6482
Mailing Address - Street 1:1541 FLORIDA AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4429
Mailing Address - Country:US
Mailing Address - Phone:209-214-7053
Mailing Address - Fax:714-428-2315
Practice Address - Street 1:1541 FLORIDA AVE
Practice Address - Street 2:STE 100
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4429
Practice Address - Country:US
Practice Address - Phone:209-575-5833
Practice Address - Fax:209-575-5836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST CHOICE PHYSICIAN PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-17
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty