Citrus Valley Urgent Care Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C2181465 Issued in CA

Legal business name

CITRUS VALLEY URGENT CARE MEDICAL GROUP, INC.

Practice address

854 Magnolia Ave
Ste. 101
Corona, CA 92879-3109

Phone

(951) 737-0910

NPI assigned

Dec 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Guy Nelson Jr., MBA

Title

Manager

Phone

(951) 737-0910

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1467635276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 MAGNOLIA AVE",
            "address_2": "STE. 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793109",
            "telephone_number": "951-737-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 MAGNOLIA AVE",
            "address_2": "STE. 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793109",
            "telephone_number": "951-737-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS VALLEY URGENT CARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GUY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "951-737-0910",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C2181465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "ZZZ23554Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Circle of Life
• Feliciano Cisneros
• Sandra Cisneros
• Victoria Cisneros
• Citrus Valley
• City of Corona
• Clarissa Doi, MD
• Alexis Renay Clark
• Anissa Clark
• Devan Clark

• Family Medicine Physician in Corona, CA
• Providers in Corona, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.