Healthcare Provider Details

I. General information

NPI: 1841563160
Provider Name (Legal Business Name): OC URGENT CARE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26781 PORTOLA PKWY 4E
FOOTHILL RANCH CA
92610-1758
US

IV. Provider business mailing address

PO BOX 2638
ANAHEIM CA
92814-0638
US

V. Phone/Fax

Practice location:
  • Phone: 949-297-3888
  • Fax:
Mailing address:
  • Phone: 949-297-3888
  • Fax:

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: NAHLA SALEM
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 949-297-3888