Healthcare Provider Details

I. General information

NPI: 1548631369
Provider Name (Legal Business Name): KOREATOWN URGENT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S VIRGIL AVE STE 101
LOS ANGELES CA
90020-1407
US

IV. Provider business mailing address

5000 AIRPORT PLAZA DR STE 150
LONG BEACH CA
90815-1275
US

V. Phone/Fax

Practice location:
  • Phone: 213-384-4000
  • Fax:
Mailing address:
  • Phone: 562-766-2000
  • 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: DR. MIN YOUNG CHA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 213-480-7770