Provider Demographics
NPI:1760862650
Name:GEORGE N. CHIDI, MD, PA
Entity Type:Organization
Organization Name:GEORGE N. CHIDI, MD, PA
Other - Org Name:MEDICROSS CLINIC & URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEIDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-272-5900
Mailing Address - Street 1:487 MAGNOLIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3306
Mailing Address - Country:US
Mailing Address - Phone:951-272-5900
Mailing Address - Fax:951-272-5950
Practice Address - Street 1:487 MAGNOLIA AVE STE 102
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3306
Practice Address - Country:US
Practice Address - Phone:951-272-5900
Practice Address - Fax:951-272-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center