Healthcare Provider Details

I. General information

NPI: 1417988668
Provider Name (Legal Business Name): EAST COUNTY URGENT CARE INDUSTRIAL & MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E MAIN ST STE 100
EL CAJON CA
92021-5211
US

IV. Provider business mailing address

1625 E MAIN ST STE 100
EL CAJON CA
92021-5211
US

V. Phone/Fax

Practice location:
  • Phone: 619-442-9896
  • Fax: 619-442-2245
Mailing address:
  • Phone: 619-442-9896
  • Fax: 619-442-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARMEN CARNEIRO-ROJAS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 619-442-9896