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General NPI Number Information
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NPI Number | 1225407596
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Entity Type | Organization
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Legal Business Name | TUSTIN URGENT CARE, APC
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 17612 E. 17TH ST
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City | TUSTIN
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State | CA
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Zip | 92780-1937
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Country | US
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Telephone | 714-243-5450
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Fax | 714-838-8944
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Provider Business Mailing Address
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Address Line | 17612 E. 17TH ST
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City | TUSTIN
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State | CA
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Zip | 92780-1937
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Country | US
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Telephone | 714-243-5450
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Fax | 714-838-8944
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZAID NOMAN
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Credential | M.D.
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Telephone | 714-243-5450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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