Healthcare Provider Details

I. General information

NPI: 1790414340
Provider Name (Legal Business Name): ANAHEIM URGENT CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22032 EL PASEO
RANCHO SANTA MARGARITA CA
92688-3947
US

IV. Provider business mailing address

1300 N LA BREA AVE
LOS ANGELES CA
90028-7504
US

V. Phone/Fax

Practice location:
  • Phone: 949-546-9958
  • Fax: 949-269-6671
Mailing address:
  • Phone: 323-464-1336
  • 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: DIRECTOR
Credential:
Phone: 714-533-2273