Healthcare Provider Details
I. General information
NPI: 1356714174
Provider Name (Legal Business Name): DAVIS URGENT CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2015
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4515 FERMI PL 105
DAVIS CA
95618-9410
US
IV. Provider business mailing address
4515 FERMI PL 105
DAVIS CA
95618-9410
US
V. Phone/Fax
- Phone: 916-479-9110
- Fax: 916-226-2656
- Phone: 916-479-9110
- Fax: 916-226-2656
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: MS.
BEVERLY
JANE
CAPEL
Title or Position: MANAGER
Credential:
Phone: 916-479-9110