Healthcare Provider Details

I. General information

NPI: 1538768064
Provider Name (Legal Business Name): EXPRESS CARENOW, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 CENTRAL AVE STE 101
RIVERSIDE CA
92506-2930
US

IV. Provider business mailing address

4100 CENTRAL AVE STE 102
RIVERSIDE CA
92506-2930
US

V. Phone/Fax

Practice location:
  • Phone: 951-683-6830
  • Fax:
Mailing address:
  • Phone: 951-683-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEREK NGUYEN
Title or Position: OWNER
Credential: MD
Phone: 951-683-6830