Healthcare Provider Details
I. General information
NPI: 1740655208
Provider Name (Legal Business Name): DOWNTOWN URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
269 S SAN PEDRO ST
LOS ANGELES CA
90012-3808
US
IV. Provider business mailing address
269 S SAN PEDRO ST
LOS ANGELES CA
90012-3808
US
V. Phone/Fax
- Phone: 213-947-3600
- Fax: 213-947-3622
- Phone: 213-947-3600
- Fax: 213-947-3622
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PEJMAN
BOLOURIAN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 714-533-2273