Express Metabolics

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

PA16158 Issued in CA

Legal business name

EXPRESS METABOLICS

Practice address

990 Goodwin Dr
Ripon, CA 95366-9446

Phone

(209) 608-8672

NPI assigned

Oct 9, 2008

Last updated

Jul 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebekah M Lee, PA-C

Title

Owner/Clinic Manager

Phone

209698088672

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1487805370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 N MAIN ST",
            "address_2": "PMB 114",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953363208",
            "telephone_number": "209-608-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 GOODWIN DR",
            "city": "RIPON",
            "state": "CA",
            "postal_code": "953669446",
            "telephone_number": "209-608-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS METABOLICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/CLINIC MANAGER",
        "authorized_official_telephone_number": "209698088672",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "PA16158",
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Duncan
• Daryl Ray Dutter, M.D.
• John Ebster, PHYSICAL THERAPY
• Yasmeen Elsumri, BSN, RN
• Anne Engdahl, PHARMD
• Lisa Fannin, M.S.,CCC-SLP
• Thomas Ferry, CCP
• Angelica Galvan
• Sherry Saji George
• Tyler Goslinga, PT

• Health Service Clinic/Center in Ripon, CA
• Providers in Ripon, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.