Healthcare Provider Details

I. General information

NPI: 1124699210
Provider Name (Legal Business Name): LINDERO URGENT CARE & MED SPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 LINDERO CANYON RD
OAK PARK CA
91377-5456
US

IV. Provider business mailing address

630 LINDERO CANYON RD
OAK PARK CA
91377-5456
US

V. Phone/Fax

Practice location:
  • Phone: 818-963-8188
  • Fax:
Mailing address:
  • Phone: 818-706-6555
  • 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: PHILIP LEE
Title or Position: MD
Credential: MD
Phone: 818-706-6555