| Providence Express Care | |
|
57 Prism Irvine CA 92618-3148 | |
| (818) 847-6881 | |
| Not Available |
| Full Name | Providence Express Care |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 57 Prism, Irvine, California |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Express Care Po Box 9602 Mission Hills CA 91346-9602 Ph: (818) 837-5637 | Providence Express Care 57 Prism Irvine CA 92618-3148 Ph: (818) 847-6881 |
| NPI Number | 1891348447 |
|---|---|
| Provider Enumeration Date | 07/23/2019 |
| Last Update Date | 03/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891348447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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