Healthcare Provider Details
I. General information
NPI: 1821085911
Provider Name (Legal Business Name): RAPIDCARE URGENT CARE CENTERS/SO CALIF. URGENT CARE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1130 W OLIVE AVE
BURBANK CA
91506-2214
US
IV. Provider business mailing address
1130 W OLIVE AVE
BURBANK CA
91506-2214
US
V. Phone/Fax
- Phone: 818-843-8555
- Fax: 818-840-7014
- Phone: 818-843-8555
- Fax: 818-840-7014
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | ZZZ28279Z |
| License Number State | CA |
VIII. Authorized Official
Name:
ARA
TAVITIAN
Title or Position: OWNER
Credential: M.D.
Phone: 818-843-8555