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General NPI Number Information
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NPI Number | 1548238256
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Entity Type | Organization
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Legal Business Name | NEWBURY PARK URGENT CARE
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2080 NEWBURY RD
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City | NEWBURY PARK
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State | CA
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Zip | 91320-3387
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Country | US
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Telephone | 805-499-0308
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Fax |
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Provider Business Mailing Address
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Address Line | 177 RIMROCK RD
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-5223
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Country | US
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Telephone | 805-557-2709
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. LYNETTE M HENRIOD
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Credential |
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Telephone | 805-499-0308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PA13286
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License Number State | CA
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