Healthcare Provider Details

I. General information

NPI: 1508454224
Provider Name (Legal Business Name): ANAHEIM URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 PAINTER AVE STE 104
WHITTIER CA
90602-3164
US

IV. Provider business mailing address

1300 N LA BREA AVE
LOS ANGELES CA
90028-7504
US

V. Phone/Fax

Practice location:
  • Phone: 562-758-2345
  • Fax: 562-758-2696
Mailing address:
  • Phone: 323-464-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMALA PRATT
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 714-533-2273