MEDICARE: FOOTHILL URGENT CARE CLINIC

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1346177912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOTHILL URGENT CARE CLINIC

Provider Business Mailing Address
First Line	:	8027 FOOTHILL BLVD
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-2957
Country	:	US
Telephone Number	:	747-342-0022
Fax Number	:	747-342-0222

Provider Business Practice Location Address
First Line	:	8027 FOOTHILL BLVD
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-2957
Country	:	US
Telephone Number	:	747-342-0022
Fax Number	:	747-342-0222

Authorized Official
Title or Position	:	CEO
Name	:	EDWARD DAVTYAN
Credential	:	MD
Telephone Number	:	747-342-0022

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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