Healthcare Provider Details

I. General information

NPI: 1265854673
Provider Name (Legal Business Name): PASADENA URGENT CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

797 S ARROYO PKWY
PASADENA CA
91105-3234
US

IV. Provider business mailing address

PO BOX 1075
DANA POINT CA
92629-5075
US

V. Phone/Fax

Practice location:
  • Phone: 626-304-0404
  • Fax: 626-304-0405
Mailing address:
  • Phone: 626-304-0404
  • Fax: 626-304-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA95190
License Number StateCA

VIII. Authorized Official

Name: DR. MARC HOWARD SHOMER
Title or Position: CEO
Credential: MD
Phone: 626-304-0404