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General NPI Number Information
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NPI Number | 1356394480
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Entity Type | Organization
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Legal Business Name | REGENCY URGENT CARE MEDICAL CORP
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 1429 COLUSA HWY SUITE B
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City | YUBA CITY
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State | CA
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Zip | 95993
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Country | US
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Telephone | 530-674-7000
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Fax | 530-755-3219
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Provider Business Mailing Address
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Address Line | 1429 COLUSA HWY SUITE B
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City | YUBA CITY
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State | CA
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Zip | 95993-9092
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Country | US
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Telephone | 530-674-7000
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Fax | 530-755-3219
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Authorized Official
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Title or Position | MEDICAL DIRECTOR CEO
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Name | DR. FAUFOUINA A AFATO
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Credential | MD
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Telephone | 550-674-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 4476370001
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License Number State | CA
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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 | G76223
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License Number State | CA
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