Healthcare Provider Details

I. General information

NPI: 1457768913
Provider Name (Legal Business Name): EAST WEST URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38345 30TH ST E STE B1A
PALMDALE CA
93550-6508
US

IV. Provider business mailing address

38345 30TH ST E STE B-1A
PALMDALE CA
93550-6508
US

V. Phone/Fax

Practice location:
  • Phone: 661-310-3388
  • Fax: 661-526-0101
Mailing address:
  • Phone: 661-310-3388
  • Fax: 661-526-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number20139
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number20139
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number20139
License Number StateCA

VIII. Authorized Official

Name: MR. ASHWANI BATRA
Title or Position: OWNER
Credential: MBBS, MSN, NP-BC
Phone: 661-310-3388