Healthcare Provider Details

I. General information

NPI: 1467960914
Provider Name (Legal Business Name): ANAHEIM URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

831 S STATE COLLEGE BLVD
ANAHEIM CA
92806-4613
US

V. Phone/Fax

Practice location:
  • Phone: 626-844-8848
  • Fax: 626-844-3688
Mailing address:
  • Phone:
  • 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: JAMALA PRATT
Title or Position: MANAGER
Credential:
Phone: 714-533-2273