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General NPI Number Information
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NPI Number | 1124796362
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Entity Type | Organization
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Legal Business Name | EXECUTIVE URGENT CARE CENTERS INC
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 74785 HWY 111, SUITE 100
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City | INDIAN WELLS
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State | CA
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Zip | 92210
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Country | US
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Telephone | 760-346-3939
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Fax |
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Provider Business Mailing Address
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Address Line | 74785 HWY 111, STE 100
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City | INDIAN WELLS
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State | CA
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Zip | 92210
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Country | US
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Telephone | 760-346-3932
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BOHDAN OLESNICKY
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Credential | MD
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Telephone | 760-464-2131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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