MEDICARE: WALK-IN MEDICAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	A42292	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05D1073086	OTHER	CA	CLIA

General Provider Information

NPI Number	:	1255561296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALK-IN MEDICAL CARE

Provider Business Mailing Address
First Line	:	3760 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3409
Country	:	US
Telephone Number	:	562-595-7467
Fax Number	:	562-402-2214

Provider Business Practice Location Address
First Line	:	3760 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3409
Country	:	US
Telephone Number	:	562-595-7467
Fax Number	:	562-402-2214

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KAILASH R. DHAMIJA
Credential	:	M.D.
Telephone Number	:	562-595-7467

Provider Enumeration Date	:	07/24/2009
Last Update Date	:	07/24/2009

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Directions to “WALK-IN MEDICAL CARE ” Practice Location

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