Healthcare Provider Details

I. General information

NPI: 1124692314
Provider Name (Legal Business Name): OC URGENTCARE MEDICAL GROUP INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S BROOKHURST ST
ANAHEIM CA
92804-4302
US

IV. Provider business mailing address

PO BOX 2638
ANAHEIM CA
92814-0638
US

V. Phone/Fax

Practice location:
  • Phone: 714-683-0644
  • Fax: 714-683-0641
Mailing address:
  • Phone: 714-991-5700
  • Fax: 714-991-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NAHLA H. SALEM
Title or Position: PRESIDENT
Credential: MD
Phone: 714-991-5700