Healthcare Provider Details

I. General information

NPI: 1043734924
Provider Name (Legal Business Name): AMERICAN URGENT CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18840 VENTURA BLVD STE 110
TARZANA CA
91356-3301
US

IV. Provider business mailing address

18840 VENTURA BLVD STE 110
TARZANA CA
91356-3301
US

V. Phone/Fax

Practice location:
  • Phone: 123-456-7891
  • Fax:
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: ROBERT NEWMAN
Title or Position: MD
Credential:
Phone: 310-339-7228