Healthcare Provider Details

I. General information

NPI: 1912590803
Provider Name (Legal Business Name): OPTIMA URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5256 S MISSION RD STE 1201
BONSALL CA
92003-3624
US

IV. Provider business mailing address

5256 S MISSION RD STE 1201
BONSALL CA
92003-3624
US

V. Phone/Fax

Practice location:
  • Phone: 760-502-0911
  • Fax: 760-502-0912
Mailing address:
  • Phone: 760-502-0911
  • Fax: 760-502-0912

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: SARA KESHAVARZI
Title or Position: CEO
Credential: FNP
Phone: 760-691-9392