Healthcare Provider Details

I. General information

NPI: 1043676216
Provider Name (Legal Business Name): CALIFORNIA URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2016
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 S BASCOM AVE STE 700
CAMPBELL CA
95008-2205
US

IV. Provider business mailing address

645 E STATE HIGHWAY 121 STE 600
COPPELL TX
75019-7942
US

V. Phone/Fax

Practice location:
  • Phone: 408-879-2616
  • Fax:
Mailing address:
  • Phone: 972-906-8162
  • 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: MR. TIMOTHY MILLER
Title or Position: VP URGENT CARE SERVICES
Credential:
Phone: 408-879-2616