Healthcare Provider Details

I. General information

NPI: 1982226460
Provider Name (Legal Business Name): EASTVALE URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14252 SCHLEISMAN RD
EASTVALE CA
92880
US

IV. Provider business mailing address

14252 SCHLEISMAN RD
EASTVALE CA
92880
US

V. Phone/Fax

Practice location:
  • Phone: 951-549-0900
  • Fax: 951-278-2848
Mailing address:
  • Phone: 951-549-0900
  • Fax: 951-278-2848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. NASER W AZAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 951-549-0900