Provider Demographics
NPI:1699864215
Name:COR HEALTHCARE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:COR HEALTHCARE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANKUSH
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHHABRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:310-257-0508
Mailing Address - Street 1:1360 W. 6TH ST.
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3581
Mailing Address - Country:US
Mailing Address - Phone:310-547-9922
Mailing Address - Fax:310-781-1425
Practice Address - Street 1:2841 LOMITA BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5100
Practice Address - Country:US
Practice Address - Phone:310-257-0508
Practice Address - Fax:310-325-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13227AMedicare ID - Type Unspecified
CAHW13227Medicare ID - Type Unspecified
CAW13227DMedicare ID - Type Unspecified
CAW13227FMedicare ID - Type Unspecified
CAHW13227BMedicare ID - Type Unspecified
CAW13227Medicare ID - Type Unspecified