Healthcare Provider Details

I. General information

NPI: 1588024061
Provider Name (Legal Business Name): DTLA URGENT CARE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2016
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 S HEWITT ST # B
LOS ANGELES CA
90013
US

IV. Provider business mailing address

431 S HEWITT ST # B
LOS ANGELES CA
90013-2215
US

V. Phone/Fax

Practice location:
  • Phone: 909-982-8044
  • Fax:
Mailing address:
  • Phone:
  • 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: JALAL BADDAY
Title or Position: PRESIDENT
Credential: MD
Phone: 909-982-8044