Healthcare Provider Details

I. General information

NPI: 1770979106
Provider Name (Legal Business Name): URGENT CARE 3D INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 HIDDEN VALLEY RD SUITE 150
CARLSBAD CA
92011-4213
US

IV. Provider business mailing address

6010 HIDDEN VALLEY RD SUITE 150
CARLSBAD CA
92011-4213
US

V. Phone/Fax

Practice location:
  • Phone: 760-544-8233
  • Fax:
Mailing address:
  • Phone: 760-544-8233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DESMOND LEVIN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 760-544-8233