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General NPI Number Information
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NPI Number | 1780816017
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Entity Type | Organization
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Legal Business Name | MODESTO URGENT CARE INC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 1908 COFFEE RD SUITE 3
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City | MODESTO
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State | CA
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Zip | 95355-2719
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Country | US
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Telephone | 209-529-1542
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2906
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City | TURLOCK
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State | CA
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Zip | 95381-2906
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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 | PHYSICIAN
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Name | DR. MIN H WU
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Credential | M.D, M.S.
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Telephone | 209-241-6308
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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 | A89677
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License Number State | CA
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