Healthcare Provider Details

I. General information

NPI: 1619846805
Provider Name (Legal Business Name): SAN ANTONIO URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 S LA BREA AVE
INGLEWOOD CA
90301-2321
US

IV. Provider business mailing address

409 S LA BREA AVE
INGLEWOOD CA
90301-2321
US

V. Phone/Fax

Practice location:
  • Phone: 310-673-1922
  • Fax: 310-810-2186
Mailing address:
  • Phone: 310-673-1922
  • Fax: 310-810-2186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLOS LUARCA
Title or Position: CEO
Credential: P.A.-C
Phone: 310-673-1922