Healthcare Provider Details

I. General information

NPI: 1497001200
Provider Name (Legal Business Name): ORANGE COUNTY URGENT CARE #3, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 E IMPERIAL HWY
BREA CA
92821-6114
US

IV. Provider business mailing address

2415 E IMPERIAL HWY
BREA CA
92821-6114
US

V. Phone/Fax

Practice location:
  • Phone: 469-893-2049
  • Fax:
Mailing address:
  • Phone:
  • 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: ERIC ENDERLE
Title or Position: CEO
Credential:
Phone: 615-600-4120