Healthcare Provider Details

I. General information

NPI: 1295127546
Provider Name (Legal Business Name): ANAHEIM URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9726 VENICE BLVD
CULVER CITY CA
90232-2717
US

IV. Provider business mailing address

9726 VENICE BLVD
CULVER CITY CA
90232-2717
US

V. Phone/Fax

Practice location:
  • Phone: 310-202-1300
  • Fax: 310-202-1900
Mailing address:
  • Phone: 310-202-1300
  • Fax: 310-202-1900

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: DR. PEJMAN BOLOURIAN
Title or Position: SECRETARY
Credential: M.D.
Phone: 714-533-2273