Healthcare Provider Details

I. General information

NPI: 1124241849
Provider Name (Legal Business Name): CLOVIS URGENT CARE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 CLOVIS AVE
CLOVIS CA
93612-3915
US

IV. Provider business mailing address

5000 HOPYARD RD SUITE 100
PLEASANTON CA
94588-3348
US

V. Phone/Fax

Practice location:
  • Phone: 559-294-1162
  • Fax:
Mailing address:
  • Phone: 925-924-1600
  • 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: RICHARD CARVOLTH
Title or Position: CEO
Credential: MD
Phone: 925-924-1600