Healthcare Provider Details
I. General information
NPI: 1093226037
Provider Name (Legal Business Name): EASYACCESS CARE IPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2017
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
222 E COLE BLVD
CALEXICO CA
92231-3211
US
IV. Provider business mailing address
222 E COLE BLVD
CALEXICO CA
92231-3211
US
V. Phone/Fax
- Phone: 760-352-2551
- Fax: 442-615-2060
- Phone: 760-352-2551
- Fax: 442-615-2060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | A111104 |
| License Number State | CA |
VIII. Authorized Official
Name:
JOHN
M
STRONG
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 442-283-3494