Healthcare Provider Details

I. General information

NPI: 1043504103
Provider Name (Legal Business Name): HOAG URGENT CARE - RSM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18231 IRVINE BLVD STE 204
TUSTIN CA
92780-3432
US

IV. Provider business mailing address

18231 IRVINE BLVD STE 204
TUSTIN CA
92780-3432
US

V. Phone/Fax

Practice location:
  • Phone: 714-389-5700
  • Fax: 714-389-6973
Mailing address:
  • Phone: 714-389-5700
  • Fax: 714-389-6973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License NumberG34265
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberG34265
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberG34265
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberG34265
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT C AMSTER
Title or Position: OWNER
Credential: MD
Phone: 714-389-5700