Healthcare Provider Details
I. General information
NPI: 1134889652
Provider Name (Legal Business Name): TUSTIN URGENT CARE, APC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/23/2021
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11741 VALLEY VIEW ST UNIT A-C
CYPRESS CA
90630-5500
US
IV. Provider business mailing address
11741 VALLEY VIEW ST UNIT A-C
CYPRESS CA
90630-5500
US
V. Phone/Fax
- Phone: 714-947-2660
- Fax: 714-947-2661
- Phone: 714-947-2600
- Fax: 714-947-2661
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZAID
NOMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 949-548-8400