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General NPI Number Information
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NPI Number | 1265099584
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Entity Type | Organization
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Legal Business Name | OHANA URGENT CARE GROUP, INC
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 6260 EL CAMINO REAL SUITE 101
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City | CARLSBAD
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State | CA
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Zip | 92009
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Country | US
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Telephone | 760-448-6650
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Fax | 760-448-6647
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Provider Business Mailing Address
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Address Line | 6260 EL CAMINO REAL SUITE 101
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City | CARLSBAD
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State | CA
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Zip | 92009
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Country | US
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Telephone | 760-448-6650
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Fax | 760-448-6647
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIVIAN WAN I CARLTON
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Credential | PA-C
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Telephone | 760-448-6650
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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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