Healthcare Provider Details

I. General information

NPI: 1962680033
Provider Name (Legal Business Name): ANAHEIM URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 S STATE COLLEGE BLVD
ANAHEIM CA
92806-4613
US

IV. Provider business mailing address

1300 N LA BREA AVE
LOS ANGELES CA
90028-7504
US

V. Phone/Fax

Practice location:
  • Phone: 714-533-2273
  • Fax: 714-635-2273
Mailing address:
  • Phone: 323-464-1336
  • Fax: 714-635-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PEJMAN BOLOURIAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 714-533-2273