Healthcare Provider Details

I. General information

NPI: 1306196712
Provider Name (Legal Business Name): WEST COAST URGENT CARE CENTERS - PASADENA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S LAKE AVE SUITE 105
PASADENA CA
91106-3955
US

IV. Provider business mailing address

PO BOX 688
PACIFIC PALISADES CA
90272-0688
US

V. Phone/Fax

Practice location:
  • Phone: 310-780-0014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA78104
License Number StateCA

VIII. Authorized Official

Name: MR. WALTER CALE
Title or Position: PRESIDENT
Credential:
Phone: 310-780-0014