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General NPI Number Information
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NPI Number | 1104075522
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Entity Type | Organization
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Legal Business Name | EXPRESS LANE URGENT CARE INC.
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 711 E HAWKEYE AVE SUITE #3
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City | TURLOCK
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State | CA
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Zip | 95380-7505
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Country | US
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Telephone | 209-664-1550
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Fax | 209-664-1548
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Provider Business Mailing Address
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Address Line | 711 E HAWKEYE AVE SUITE #3
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City | TURLOCK
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State | CA
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Zip | 95380-7505
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Country | US
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Telephone | 209-664-1550
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Fax | 209-664-1548
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | PAUL ANDERSON
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Credential |
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Telephone | 209-664-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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