# NATIONWIDE HEALTHCARE PROVIDER CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700612900
- **Authorized official:** RYAN HILTON (OWNER)
- **Authorized official phone:** (305) 332-0669

## Contact information

- **Practice address:** 20505 CRESCENT BAY DR, LAKE FOREST, CA 92630-8825
- **Practice address phone:** (949) 505-4313
- **Mailing address:** 20505 CRESCENT BAY DR, LAKE FOREST, CA 92630-8825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 202C00000X | Independent Medical Examiner Physician | — | NULL | Yes |
| 202C00000X | Independent Medical Examiner Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2024
- **Last updated:** 09/12/2024