Provider Demographics
NPI:1194822601
Name:HEALTH CARE EXPRESS MEDICAL CORPORATION
Entity type:Organization
Organization Name:HEALTH CARE EXPRESS MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:T
Authorized Official - Last Name:KERRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-360-0333
Mailing Address - Street 1:42575 WASHINGTON ST # B
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-8850
Mailing Address - Country:US
Mailing Address - Phone:760-360-0333
Mailing Address - Fax:760-360-1368
Practice Address - Street 1:42575 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-8850
Practice Address - Country:US
Practice Address - Phone:760-360-0333
Practice Address - Fax:760-360-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23493ZMedicare PIN