Healthcare Provider Details

I. General information

NPI: 1629470489
Provider Name (Legal Business Name): TWEEDY URGENT CARE INC.APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 TWEEDY BLVD
SOUTH GATE CA
90280-5538
US

IV. Provider business mailing address

2809 TWEEDY BLVD
SOUTH GATE CA
90280-5538
US

V. Phone/Fax

Practice location:
  • Phone: 323-567-9919
  • Fax: 323-567-9902
Mailing address:
  • Phone: 323-567-9919
  • Fax: 323-567-9902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA44541
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN BARKODAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 323-567-9919