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General NPI Number Information
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NPI Number | 1770396723
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Entity Type | Organization
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Legal Business Name | SPECIALIZED URGENT CARE
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 7710 LIMONITE AVE STE 101
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City | JURUPA VALLEY
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State | CA
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Zip | 92509-5342
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Country | US
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Telephone | 714-768-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 7710 LIMONITE AVE STE 101
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City | JURUPA VALLEY
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State | CA
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Zip | 92509-5342
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Country | US
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Telephone | 951-380-8202
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Fax | 951-498-4114
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAREK EZZEDDINE
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Credential | MD
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Telephone | 951-380-8203
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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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