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General NPI Number Information
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NPI Number | 1730894148
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Entity Type | Organization
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Legal Business Name | OC URGENTCARE MEDICAL GROUP, INC
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 23653 EL TORO RD STE B
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City | LAKE FOREST
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State | CA
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Zip | 92630-8614
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Country | US
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Telephone | 949-317-0312
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2638
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City | ANAHEIM
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State | CA
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Zip | 92814-0638
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | NAHLA H. SALEM
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Credential |
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Telephone | 248-508-6131
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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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