Provider Demographics
NPI:1255179560
Name:TRUECARE DPC
Entity type:Organization
Organization Name:TRUECARE DPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:GOLFRAN
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:910-758-1769
Mailing Address - Street 1:414 RAY AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4916
Mailing Address - Country:US
Mailing Address - Phone:910-758-1769
Mailing Address - Fax:910-348-5805
Practice Address - Street 1:1790 METROMEDICAL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3861
Practice Address - Country:US
Practice Address - Phone:910-758-1769
Practice Address - Fax:910-348-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty