Healthcare Provider Details
I. General information
NPI: 1578137618
Provider Name (Legal Business Name): OC URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2021
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
610 E KATELLA AVE
ORANGE CA
92867-4954
US
IV. Provider business mailing address
PO BOX 2638
ANAHEIM CA
92814-0638
US
V. Phone/Fax
- Phone: 714-694-2001
- Fax: 714-694-2122
- Phone: 714-991-5700
- Fax: 714-683-0645
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:
NAHLA
H.
SALEM
Title or Position: PRESIDENT
Credential: MD
Phone: 714-991-5700