Healthcare Provider Details
I. General information
NPI: 1851867246
Provider Name (Legal Business Name): AMERICAN CURRENT CARE OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3663 ARCH RD STE 400
STOCKTON CA
95215-8315
US
IV. Provider business mailing address
5080 SPECTRUM DR STE 1200W
ADDISON TX
75001-4624
US
V. Phone/Fax
- Phone: 209-943-2202
- Fax: 209-943-2209
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
ANDERSON
Title or Position: VP
Credential:
Phone: 972-364-8000