Healthcare Provider Details

I. General information

NPI: 1760689715
Provider Name (Legal Business Name): TOTALCARE WALK IN CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13768 ROSWELL AVE SUITE 118
CHINO CA
91710-1401
US

IV. Provider business mailing address

13768 ROSWELL AVE SUITE 118
CHINO CA
91710-1401
US

V. Phone/Fax

Practice location:
  • Phone: 909-591-8200
  • Fax: 866-701-9305
Mailing address:
  • Phone: 909-591-8200
  • Fax: 909-591-8229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal 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: DR. XIAO-LING ZHANG
Title or Position: CFO
Credential: M.D.
Phone: 909-591-8200