Healthcare Provider Details

I. General information

NPI: 1538104492
Provider Name (Legal Business Name): WESTLAKE VILLAGE URGENT CARE OCC FAM MED CL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 TOWNSGATE ROAD SUITE #103
WESTLAKE VILLAGE CA
91361
US

IV. Provider business mailing address

4607 LAKEVIEW CANYON #404
WESTLAKE VILLAGE CA
91361
US

V. Phone/Fax

Practice location:
  • Phone: 805-379-9125
  • Fax: 805-379-2311
Mailing address:
  • Phone: 805-379-9125
  • Fax: 805-379-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberA67070
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA607070
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA67070
License Number StateCA

VIII. Authorized Official

Name: DR. SONIA DEVGAN-KACKER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 818-874-0900