Healthcare Provider Details

I. General information

NPI: 1134791338
Provider Name (Legal Business Name): TOKYO URGENT CARE A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S ALAMEDA ST STE 203
LOS ANGELES CA
90013-1734
US

IV. Provider business mailing address

3111 LOS FELIZ BLVD STE 102
LOS ANGELES CA
90039-1599
US

V. Phone/Fax

Practice location:
  • Phone: 909-723-0057
  • Fax:
Mailing address:
  • Phone: 909-723-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH LOCHINVAR DINGLASAN SR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-723-0057