Healthcare Provider Details

I. General information

NPI: 1952709305
Provider Name (Legal Business Name): ELITE URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 STANDIFORD AVE SUITE F
MODESTO CA
95350-1159
US

IV. Provider business mailing address

1524 MCHENRY AVE SUITE 340
MODESTO CA
95350-4500
US

V. Phone/Fax

Practice location:
  • Phone: 209-579-5628
  • Fax: 209-579-5637
Mailing address:
  • Phone: 209-545-9555
  • Fax: 209-545-9559

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: AMRIK BASI
Title or Position: MD
Credential: MD
Phone: 209-545-9555