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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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