Organization
DV URGENT CARE MEDICAL GROUP, INC.
Active
Other names
DV Urgent Care and Occupational Health
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA CASAREZ (OFFICE MANAGER)
(909) 948-8050
Entity
Organization
Contact information
Practice address
6080 HAMNER AVE, SUITE# 100, EASTVALE, CA 91752-3662
(951) 361-0104
Mailing address
PO BOX 2967, RANCHO CUCAMONGA, CA 91729-2967
(909) 948-8050
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
20A6930
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ65330Y
BLUE SHIELD
CA
Enumeration date
08/19/2010
Last updated
03/16/2011
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