Healthcare Provider Details

I. General information

NPI: 1386160810
Provider Name (Legal Business Name): EASYACCESS MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E COLE BLVD
CALEXICO CA
92231-3211
US

IV. Provider business mailing address

1699 N IMPERIAL AVE
EL CENTRO CA
92243-1320
US

V. Phone/Fax

Practice location:
  • Phone: 760-352-2551
  • Fax: 888-631-5150
Mailing address:
  • Phone: 760-352-2551
  • Fax: 888-631-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIEN VO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 760-352-2551