=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265250476
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AURORA URGENT CARE, APC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2024
-----------------------------------------------------
Last Update Date | 09/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1665 S IMPERIAL AVE STE C
-----------------------------------------------------
City | EL CENTRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92243-4247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-592-4783
-----------------------------------------------------
Fax | 877-673-1604
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2580 HIDDEN VALLEY RD
-----------------------------------------------------
City | LA JOLLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92037-4022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-592-4783
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. UNNATI SAMPAT
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 760-592-4783
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------