Healthcare Provider Details

I. General information

NPI: 1780816017
Provider Name (Legal Business Name): MODESTO URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 COFFEE RD SUITE 3
MODESTO CA
95355-2719
US

IV. Provider business mailing address

PO BOX 2906
TURLOCK CA
95381-2906
US

V. Phone/Fax

Practice location:
  • Phone: 209-529-1542
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA89677
License Number StateCA

VIII. Authorized Official

Name: DR. MIN H WU
Title or Position: PHYSICIAN
Credential: M.D, M.S.
Phone: 209-241-6308