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General NPI Number Information
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NPI Number | 1669778965
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Entity Type | Organization
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Legal Business Name | PARTNERS URGENT CARE-EASTLAKE
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 2315 OTAY LAKES RD
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City | CHULA VISTA
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State | CA
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Zip | 91915-1162
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Country | US
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Telephone | 714-389-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 18231 IRVINE BLVD STE 204
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City | TUSTIN
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State | CA
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Zip | 92780-3432
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Country | US
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Telephone | 714-389-5700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT CRAIG AMSTER
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Credential | MD
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Telephone | 714-389-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | G34265
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | G34265
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | G34265
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License Number State | CA
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