Healthcare Provider Details

I. General information

NPI: 1063256386
Provider Name (Legal Business Name): URGENT POINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18056 WIKA RD STE C
APPLE VALLEY CA
92307-2194
US

IV. Provider business mailing address

2554 LINCOLN BLVD # 196
VENICE CA
90291-5043
US

V. Phone/Fax

Practice location:
  • Phone: 760-628-2021
  • Fax: 760-867-3292
Mailing address:
  • Phone: 760-628-2021
  • Fax: 760-867-3302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS JOYCE LIN
Title or Position: CONTROLLER
Credential:
Phone: 323-452-7062