Healthcare Provider Details

I. General information

NPI: 1902646276
Provider Name (Legal Business Name): URGENT CARE 90210 INC PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2024
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 BRIGHTON WAY STE 303
BEVERLY HILLS CA
90210-4710
US

IV. Provider business mailing address

9400 BRIGHTON WAY STE 303
BEVERLY HILLS CA
90210-4710
US

V. Phone/Fax

Practice location:
  • Phone: 310-683-0180
  • Fax:
Mailing address:
  • Phone: 310-683-0180
  • Fax:

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: DR. EHSAN ALI
Title or Position: PRESIDENT
Credential: MD
Phone: 310-683-0180