Healthcare Provider Details

I. General information

NPI: 1518953298
Provider Name (Legal Business Name): HEALTHCARE CROSSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39765 DATE ST STE 102
MURRIETA CA
92563-2005
US

IV. Provider business mailing address

39765 DATE ST STE 102
MURRIETA CA
92563-2005
US

V. Phone/Fax

Practice location:
  • Phone: 951-894-4665
  • Fax: 951-894-4667
Mailing address:
  • Phone: 951-894-4665
  • Fax: 951-894-5178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: VICTOR NGUYEN
Title or Position: MD
Credential:
Phone: 951-894-4665