Healthcare Provider Details

I. General information

NPI: 1710667118
Provider Name (Legal Business Name): EXPRESS URGENTCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 10/07/2023
Certification Date: 10/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 N DIAMOND BAR BLVD STE 102103
DIAMOND BAR CA
91765-1023
US

IV. Provider business mailing address

1523 AVENIDA ENTRADA
SAN DIMAS CA
91773-4007
US

V. Phone/Fax

Practice location:
  • Phone: 443-275-3605
  • Fax:
Mailing address:
  • Phone: 909-718-2455
  • Fax: 909-718-2454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AMRIT PAL DHILLON
Title or Position: DIRECTOR/CHEIF EXECUTIVE OFFICER
Credential: PHYSICIAN ASSISTANT
Phone: 909-718-2455