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Organization
CITRUS VALLEY URGENT CARE MEDICAL GROUP, INC.
Active
Organization
CITRUS VALLEY URGENT CARE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GUY NELSON JR. MBA (MANAGER)
(951) 737-0910
Entity
Organization
Contact information
Practice address
854 MAGNOLIA AVE, STE. 101, CORONA, CA 92879-3109
(951) 737-0910
Mailing address
854 MAGNOLIA AVE, STE. 101, CORONA, CA 92879-3109
(951) 737-0910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C2181465
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ23554Z
MEDICARE GROUP ID
CA
Enumeration date
12/14/2007
Last updated
12/14/2007
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