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NPI Code Detail

MEDICARE: MR. DARRELL PRICE

MEDICARE: MR. DARRELL PRICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1609990878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DARRELL PRICE
Provider Business Mailing Address
First Line : 3625 14TH ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3815
Country : US
Telephone Number : 951-955-1517
Fax Number :
Provider Business Practice Location Address
First Line : 3625 14TH ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3815
Country : US
Telephone Number : 951-955-1517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 05/28/2014

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Directions to “ MR. DARRELL PRICE ” Practice Location

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