Healthcare Provider Details

I. General information

NPI: 1619494036
Provider Name (Legal Business Name): WEST HOLLYWOOD URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N LA BREA AVE
LOS ANGELES CA
90028-7504
US

IV. Provider business mailing address

831 S STATE COLLEGE BLVD
ANAHEIM CA
92806-4613
US

V. Phone/Fax

Practice location:
  • Phone: 323-464-1336
  • Fax: 323-464-2163
Mailing address:
  • Phone: 714-533-2273
  • Fax: 714-635-2273

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: JAMALA PRATT
Title or Position: MANAGER
Credential:
Phone: 714-533-2273