Provider Demographics
NPI:1710667118
Name:EXPRESS URGENTCARE INC
Entity Type:Organization
Organization Name:EXPRESS URGENTCARE INC
Other - Org Name:EXPRESS URGENTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMRIT PAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIAN ASSISTANT
Authorized Official - Phone:909-718-2455
Mailing Address - Street 1:1523 AVENIDA ENTRADA
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4007
Mailing Address - Country:US
Mailing Address - Phone:909-718-2455
Mailing Address - Fax:909-718-2454
Practice Address - Street 1:750 N DIAMOND BAR BLVD STE 102103
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1023
Practice Address - Country:US
Practice Address - Phone:443-275-3605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty