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General NPI Number Information
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NPI Number | 1962746404
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Entity Type | Organization
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Legal Business Name | CMG EXPRESS CARE, INC
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | 4100 CENTRAL AVE #101
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City | RIVERSIDE
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State | CA
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Zip | 92506-2933
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Country | US
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Telephone | 951-824-7887
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Fax | 951-680-1606
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Provider Business Mailing Address
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Address Line | 4100 CENTRAL AVE #101
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City | RIVERSIDE
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State | CA
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Zip | 92506-2933
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Country | US
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Telephone | 951-824-7887
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Fax | 951-680-1606
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDRO N SHAROBIEM
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Credential | MD
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Telephone | 951-824-7887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A100752
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License Number State | CA
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